Evaluating Efficacy of Spinal Manipulation on Primary Dysmenorrhea

Abstract

Background: This study was performed to determine the effect of manual spinal manipulation on pain reduction in primary dysmenorrhea.

Methods: The 37 participants were randomly assigned to the intervention and control groups. All patients underwent spinal examinations on day 15 of their cycle. In addition, their lumbosacral range of motion was analyzed using a Zebris machine and their thoracolumbar range of motion was measured using a goniometer. Patients in the intervention group received spinal manipulation on day 15, 21, and 28 of their second menstruation cycle. Patients in both groups performed 6 exercises consisting of stretching and strengthening exercises which were begun on day 15 of their second cycle and stopped with menstruation onset. Follow-up was performed for 3 consecutive cycles in both groups.

Results: Of the 37 patients who entered the study, 32 patients were analyzed. The mean age of patients was 27.68 years and their pain score was generally higher than 5 out of 10. Paired t-test was used for variables with normal distribution and Wilcoxon test for those with non-normal distribution. The pain in the abdomen, pelvis, and lower back was decreased significantly in both groups, but the effect of manipulation + exercise was greater than exercise alone. This reduction in pain in the abdominal and pelvic region after the manipulation was significant in the 3 months of follow-up (P < 0.05). Manipulation caused a reduction in diclofenac use in all 3 cycles, but in the exercise group, a significant decrease was only observed in the first cycle. The reduction in the number of days with pain after menstruation was significant after manipulation.

Conclusion: Spinal manipulation seems to be a good alternative to medical therapy with much fewer complications.