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Pain and Spine Medicine

Chronic Post-Hysterectomy Pain and The Transformative Impact of Osteopathic Manipulative Treatment: A Case Report

Thursday, October 23, 2025
5:00 PM - 6:30 PM MT
Location: Open Kiosks

    Primary Author(s)

  • Irina Ter-Ovanesyan

    OMS-III
    Nova Southeastern University Dr Kiran C Patel College of Osteopathic Medicine
    Fort Lauderdale, Florida

    • Co-Author(s)

  • Maret Rossi (she/her/hers)

    OMS-III
    Nova Southeastern University Dr. Kiran Patel College of Osteopathic Medicine
    Davie, Florida

Disclosure(s):
Irina Ter-Ovanesyan: No financial relationships to disclose
Maret Rossi: No financial relationships to disclose
Case Diagnosis: A 41-year-old female with chronic post-hysterectomy pain

Case Description or Program Description: Patient had constant, sharp 9/10 lower abdominal and pelvic pain that progressively worsened after a hysterectomy 7 months prior. The pain was exacerbated by dyspareunia and dysuria. She was unable to lift heavy objects and had suicidal ideations due to the pain severity. Osteopathic structural exam revealed taut suprapubic fascia and radiating heat on palpation. Deep tendon reflexes were +2/4 bilaterally. Neurological exam was negative. MRI revealed mild scar tissue in the pelvic region. Multiple physicians recommended surgical intervention for scar tissue removal. Instead, the patient was treated with a variety of OMT techniques. The most effective were IMFR, visceral techniques, LAS, and BLT. She was also instructed in Kegel exercises and daily ice application. Further treatment modality details will be discussed.

Setting: Outpatient Clinic

Assessment/Results: The patient exhibited significant decrease of pelvic pain from a 9/10 to 0/10 after 3 months of once weekly OMT. The dyspareunia and dysuria completely resolved. The osteopathic structural exam confirmed decreased tenderness, hypertonicity, and emanated heat in the suprapubic region. The patient’s quality of life improved and she no longer experienced suicidal ideations.

Discussion (relevance): Previous studies demonstrate that over 30% of women have persistent chronic pain one year after a hysterectomy. Current treatments consist of physical therapy, pain medication, and nerve blocks. However, there have not been studies exploring effects of osteopathic manipulative treatment (OMT) on chronic post-hysterectomy pain. This is the first reported case, to our knowledge, that utilized OMT as the standalone treatment for chronic post-hysterectomy pain.

Conclusions: The unprecedented speed and extent of recovery achieved in this case calls for a further exploration of OMT for chronic post-hysterectomy pain due to scar tissue.