Evaluating the Effectiveness of Radiofrequency in Multimodal Physiotherapy for Postpartum Pelvic Pain: The RASDOP Protocol—A Mixed-Methods Study

<b>Background/Objectives</b>: Approximately 30% of women experience pelvic pain one year after vaginal delivery, and this increases to 50% during vaginal intercourse. Multimodal physiotherapy is the first-line treatment for myofascial pain of the pelvic floor muscles (PFM), often incorporating emerging technologies like radiofrequency, despite limited evidence supporting its use. The RASDOP study aims to (i) evaluate the effectiveness of multimodal physiotherapy combining therapeutic education, PFM training, and myofascial pain syndrome (MPS) management with or without radiofrequency, in reducing pain and improving sexual function postpartum; and (ii) explore the barriers and facilitators influencing adherence and perceived self-efficacy towards physiotherapy treatment in women with postpartum pelvic pain. <b>Methods</b>: This study employs a randomized clinical trial with a blinded examiner and two parallel groups, followed by a qualitative phenomenological study. A total of 124 postpartum women with pelvic pain (≥4 cm on the visual analogue scale) will be randomized into two groups: a multimodal physiotherapy group (therapeutic education, MPS treatment, and PFM training) and a radiofrequency + multimodal physiotherapy group (same treatment with additional non-ablative radiofrequency). Both groups will receive 12 supervised individual sessions. Assessments will be conducted pre- and post-intervention, and at 3-, 6-, and 12-month stages post-treatment. Primary outcomes include pain intensity and sexual function, while secondary outcomes involve PFM tone, strength, MPS presence, levator ani length, and distress caused by pelvic floor dysfunction. The qualitative study will utilize semi-structured interviews and focus groups analyzed thematically. <b>Results</b>: Radiofrequency is expected to enhance pain relief, sexual function, and PFM relaxation. Insights into adherence and barriers will aid in personalizing physiotherapy interventions. <b>Conclusions</b>: The RASDOP study will provide evidence on the safety and efficacy of radiofrequency in postpartum pelvic pain treatment and shed light on women's experiences to improve therapeutic outcomes.