10/31/2025
What are the Clinical Implications for Physiotherapy Practice?
To address these disparities, MSK clinicians must integrate female-specific considerations into assessment and management. This includes:
• Taking a detailed hormonal history (such as age at menarche, menstrual patterns, menopause – natural/ surgical, contraceptive use, endometriosis/ adenomyosis).
• Early menarche (typically between ages 9 and 11) has been associated with an increased risk of chronic pain conditions involving the neck, abdomen, upper limbs, and chronic widespread pain (CWP).23
• Screening for trauma and psychosocial risk factors.
• Identifying patients at risk using tools like the Örebro Musculoskeletal Pain Screening Questionnaire (OREBRO-SF) and the Central Sensitization Inventory (CSI).
• Adapting exercise interventions to account for or adapt to hormonal phases, immune system profile and psychosocial situation.
• Advanced frameworks like the Pain and Movement Reasoning Model24 offer valuable structure, which can be enhanced with a female-centred lens to integrate s*x-specific factors into clinical reasoning.
• Call for researchers to develop outcome measures that identify females at risk of persistent pain by incorporating female-specific variables such as hormonal status, trauma history, and psychosocial factors.
Furthermore, integrating exercise as a therapeutic tool must be done with caution in women with conditions like RED-S or autoimmune, where overtraining may exacerbate painful condition.25
Clinicians should also embrace person-centred care approaches, validating the patient’s lived experience, and offering shared decision-making.26 This involves explaining why certain symptoms may be hormonally modulated or psychosocially influenced without attributing pain solely to mood or stress.
Educational reform is also essential. Clinicians must be trained in s*x- and gender-based medicine and taught to critically appraise literature for s*x bias. The S*x and Gender Health Education Summit 2020 recommends that healthcare professionals develop competencies in s*x-based pain management, critical appraisal, and advocacy.
Reference: Blog by Sonam Jethwa, Australian Physiotherapist
For full article:
https://dralisongrimaldi.com/blog/women-in-pain/?mc_cid=1eee471acd&mc_eid=30ceffc272
