Managing Period Pain with Chiropractic

Menstrual cramping and low back pain are a regular part of life for many women.  Dysmenorrhea in medical terminology, is defined as menstrual pain not attributed to pelvic disease.  It is also the most common gynecological complaint in women in their reproductive years.

Various studies of different groups report a prevalence range of 20% to 94%   Results of a 2012 study help explain this wide range.  Despite it being very common, there is not a specific definition that is used across the board.  Some studies are based on any menstrual pain while others require additional symptoms to be considered Dysmenorrhea.  They found that some degree of menstrual pain was reported in 84.1% of women with about half of those reporting pain every cycle.  Upon further analysis, they were able to break down the prevalence rates more specifically:

• 84.1% – Menstrual pain only
• 55.2% – Menstrual pain requiring medication
• 31.9% – Menstrual pain causing absenteeism (from work/study/social activities)
• 25.3% Menstrual pain that required medication and caused absenteeism

The prevalence of pain affecting women on a regular basis has a significant impact of quality of life, public and occupational health.   Unfortunately, it is often a socially taboo topic.  Even among women, the pain is often undervalued as they have been told it’s a regular part of having a cycle that they just have to endure.  Without clear communication between patients and their health care providers, women may not be receiving proper treatment.

Proper diagnosis includes clinical history and physical exam.  It is important that the provider have enough information to safely rule out a more serious cause of Dysmenorrhea.   If no other diagnosis is made, that still does not mean the patient must be left to just live with it.

Because menstrual pain is “common” does not mean it is “untreatable.”

There are several ways that women can reduce the pain associated with Dysmenorrhea: medications, physical therapies, non-acidic diets, herbal supplements, eastern therapies, and the chiropractic manual adjustments of the spine.  While many experience relief with over-the-counter pain medications, researchers note medications “are invasive and pose a higher risk to long-term chemical exposure, side effects or irreversible conditions.”

Chiropractic care, on the other hand, has no risk of chemical exposure and minimal risk for other side effects.  Similar to the varied studies on prevalence of Dysmenorrhea, research has produced sometimes conflicting reports regarding chiropractic’s efficacy for menstrual pain.  However, just as researchers found clarity when they specified the meaning of Dysmenorrhea, when research is focused on specific aspects of the condition, or techniques, it reveals that chiropractic can be highly effective for many women.

In a randomized clinical trial, subjects were evaluated for underlying spinal dysfunction.  Subjects included 54 female patients that had been diagnosed with PMS and 30 who had not.  A full history, physical and chiropractic exam revealed that those who had been diagnosed with PMS had more positive responses for 11 of 12 spinal dysfunction indexes.  The difference was “statistically significant” for “cervical, thoracic, and low back tenderness, low back orthopedic testing, low back muscle weakness, and the neck disability index.”  They reported that those in the PMS group were positive for an average of 5.4 of the 12 indexes compared to an average of just 3 for the non-PMS group.  This led researchers to suggest that spinal dysfunction could be a causative factor for PMS and therefore, chiropractic spinal manipulation is a logical 1st approach for pain management these patients.

Another group of researchers conducted a prospective case series to test the effects of the chiropractic drop table technique as a treatment for dysmenorrhea.  Thirteen subjects were enrolled into the study where they were screened for symptoms of primary dysmenorrhea and motion restrictions of the lumbosacral spine.  They rated menstrual pain (abdominal, pelvic, and low back pain) at the start of the study and after each menstrual cycle.  Difficulties with lumbosacral flexion and extension were treated with drop table chiropractic spinal manipulations three times during two consecutive cycles.  All subjects rated pain levels of 5 or higher for two of the three anatomical sites (lower abdominal pain, general abdominal pain and/or lower back pain).  Most of the subjects experienced a meaningful reduction in general abdominal pain and lower back pain during the treatment phase.

Additional studies involving clearly defined diagnosis and specific techniques are needed to clarify the best treatment options for women suffering with dysmenorrhea.  In the meantime, these studies show that chiropractic care can provide a safe, effective, non-pharmacological method of pain management for many women experiencing menstrual pain.

Talk to your personal chiropractic physician about your menstrual symptoms and how spinal manipulation can help you reduce pain and maintain your normal activities during your cycle.  If you do not have a chiropractor, you can find a TCA member doctor near you at www.tnchiro.com/find-a-doctor/.

 

RESOURCES:

Spears LG. A narrative review of medical, chiropractic, and alternative health practices in the treatment of primary dysmenorrhea. J Chiropr Med. 2005 Spring;4(2):76-88. doi: 10.1016/S0899-3467(07)60117-7. PMID: 19674650; PMCID: PMC2647037.

Walsh MJ, Polus BI. The frequency of positive common spinal clinical examination findings in a sample of premenstrual syndrome sufferers. J Manipulative Physiol Ther. 1999 May;22(4):216-20. doi: 10.1016/s0161-4754(99)70047-3. PMID: 10367757.

Guimarães I, Póvoa AM. Primary Dysmenorrhea: Assessment and Treatment. Rev Bras Ginecol Obstet. 2020 Aug;42(8):501-507. English. doi: 10.1055/s-0040-1712131. Epub 2020 Jun 19. PMID: 32559803.

Denise A. Holtzman, Kristina L. Petrocco-Napuli, Jeanmarie R. Burke, Prospective Case Series on the Effects of Lumbosacral Manipulation on Dysmenorrhea, Journal of Manipulative and Physiological Therapeutics, Volume 31, Issue 3, 2008, Pages 237-246, ISSN 0161-4754, https://doi.org/10.1016/j.jmpt.2008.02.005.

Grandi G, Ferrari S, Xholli A, Cannoletta M, Palma F, Romani C, Volpe A, Cagnacci A. Prevalence of menstrual pain in young women: what is dysmenorrhea? J Pain Res. 2012;5:169-74. doi: 10.2147/JPR.S30602. Epub 2012 Jun 20. PMID: 22792003; PMCID: PMC3392715.