A scoping review of alterations in sensory and motor function, and body perception in women with chronic pelvic pain

Abstract

Chronic pelvic pain (CPP) affects 20% of women worldwide and is associated with substantial disability, yet its mechanisms remain unclear. Alterations in sensory or motor processing, and body perception, have been implicated in chronic pain conditions but the evidence has not been formally synthesised in CPP. This scoping review mapped the evidence for altered sensory function, motor function or body perception disturbance (BPD) in women with CPP. We searched multiple databases (up to April 2025) for studies of any design that explored these elements in women with CPP. We included 175 studies (19,457 participants). Most studies compared sensory and motor function with healthy controls, using quantitative sensory testing to assess sensory function, while a small group indirectly investigated BPD in this population. Pain-evoking sensory tests in the pelvic region consistently demonstrated reduced thresholds in people with CPP. Findings from remote body regions were less consistent, though evidence of widespread hypersensitivity and altered pain modulation suggested potential central involvement. Motor testing was limited and inconsistent. Central nervous system studies showed heterogeneous findings across conditions, including altered brain activity and evidence of altered sensorimotor processing. In qualitative studies, women described disconnection from, altered awareness of, and lack of perceived control over the pelvic region. Across all studies methods varied, with highly variable protocols and incomplete reporting limiting comparisons. Collectively, findings suggest emerging but inconsistent evidence for sensory, motor and body perception alterations in CPP. Future research should establish a theoretical framework, standardise methods and reporting, and integrate sensory, motor, and perceptual domains.