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Original Research Open Access

Treatment of Pelvic Pain Using Systemic Manual Therapy

  • 1Halili Physical Therapy 268 E River Rd. Suite 130 Tucson AZ 85704, USA
  • 2Rocky Mountain University of Health Professions, Provo, Utah, USA
+ Affiliations - Affiliations

Corresponding Author

Adi Halili, halilipt@msn.com

Received Date: March 01, 2026

Accepted Date: March 31, 2026

Abstract

Background: The purpose of this study is to test the effectiveness of physical therapy treatment for non-specific pelvic pain using Systemic Manual Therapy (SMT). This study evaluates outcomes across episode of care and after implementation of specific SMT protocols.

Design: Computerized decision support software (CDSS) analysis of electronic medical records (EMR) using the Halili Physical Therapy Statistical Analysis Tool (HPTSAT) to query EMR.

Methods: Changes in pelvic pain and overall symptoms were measured in 310 patients after provision of 261 SMT protocols or protocol combinations, and across episode of care using the patient identified problem scale (PIP) and a statistical analysis tool (HPTSAT).

Results: Pelvic pain was improved on average by 1.95/9 (p < 0.001), overall improvement was 11.11/90 (p < 0.001). Eighteen combinations containing 13 distinct protocols passed the HPTSAT criteria. These protocols included seven with direct effects; the five proposed for their effects on central desensitization; and one protocol with either regional or desensitization effects.

Conclusion: An effective treatment for pelvic pain is possible if in addition to direct intervention, regional contributors and central sensitization are addressed.

Keywords

Pelvic pain, Central sensitization, Systemic manual therapy, Fascial counter strain, Barral, Integrative manual therapy, Muscle energy techniques

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