Yes, we are talking about period pain today. Sadly, period pain is a reality for many people. While there are levels to that, dysmenorrhea lies at the extreme end of the spectrum, where severe pain and tenderness interferes with daily activities. Sufferers may be forced to miss days of work or school, and often have to manage their symptoms with painkiller medication or other pharmaceutical options such as the oral contraceptive pill. While the latter may mask symptoms, it rarely if ever gets to the cause of the dysmenorrhea and ceasing the pill for whatever reason would cause a relapse. Acupuncture has been used by many sufferers as a non-drug option to manage the condition, but can chiropractic help too? A new case report has added to the limited (largely case report) data that suggests this is a possibility.
While every human on the face of the planet has to deal with hormones, people with problems relating to the female menstrual cycle seem to get a particularly raw end of the deal. While Dysmenorrhea relates to pain, it is just one issue that can crop up. Amenorrhea is the absence of a period. Dysmenorrhea is menstrual pain that interferes with daily activities. Oligomenorrhea is infrequent periods occurring at intervals of greater than 35 days. These conditions may be experienced as a result of hormonal imbalance or female reproductive abnormalities. Amenorrhea is more common in elite athlete women and often the level of dysregulation/abnormality is proportional to the intensity of exercise. Eating disorders such as anorexia and bulimia can both contribute to menstrual dysregulation.
But the causes of extremely painful periods, or Oligomenorrhea can be much more difficult to nail down. This case report bears significance for a couple of reasons: the first is obviously related to the condition the patient was suffering from. The second is the fact that it might not occur to some people that they can talk to their chiropractor about things like dysmenorrhea or issues not related to back and neck pain. It’s an important fact to note.
The case at hand was a 31-year-old woman presenting for low back and foot pain. After she had been under chiropractic care for five years, she discussed the potential for acupuncture to help her cope with irregular periods. The periods she was having were only light, 1-2 days in duration and had only occurred 2-3 times a year for over 10 years. The patient was also experiencing breast tenderness every week for years, only finding relief during the infrequent menstrual periods. The patient had been receiving preventative and wellness chiropractic care for years but raising this previously undiscussed issue with her chiropractor meant a change in her care plan.
She commenced with acupuncture care, and her chiropractor began using the chiropractic manipulative reflex technique (CMRT).
In terms of acupuncture, her treatment points were decided based on symptom presentation, pulse diagnosis, and other acupuncture diagnostic tools. The main actions of these points were centred around pain and regulating menstruation. In terms of her chiropractic care, she was assessed and treated using Sacro-occipital technique (SOT) and chiropractic manipulative reflex technique (CMRT) – both specific techniques chiropractors use to check and adjust subluxations. While both of these are covered in detail in the case report, it is important to note that while different chiropractors use different techniques, they are all geared at the same thing: checking and adjusting subluxations and enabling optimal neurological function. As the brain and nervous system run the body, this can result in many different results.
The case report notes that “She was treated for a category one which involves pelvic block placement to reduce pelvic torsion and improve sacral nutation. R+C factors were used to isolate a cervical – lumbar relationship and the lumbar vertebras were adjusting in a direction and vector that would decrease cervical spine local pain and swelling. In addition, the T6-8 mid-thoracic vertebra were adjusted for anteriorities, T3/4 posterior, and C1 was rotated to the right and C2 to the left. Occipital fibre line one area six 10 was positive relating to T8 and chiropractic manipulative reflex technique (CMRT) for the liver.”
While the above paragraph is of note to chiropractors and chiropractic students specifically, it is noteworthy that the chiropractor focused on adjusting for the liver and adrenals. This is particularly significant, as the adrenals are where many of our hormones are synthesized.
So then, what happened with the patient in question?
As she was a long-term chiropractic patient, the case reports authors had the opportunity of doing one year and two-year follow-ups to see how she was doing under chiropractic and acupuncture-based care.
After one year of acupuncture and chiropractic treatment:
- Her condition improved with more regular periods in a monthly cycle.
- During times of high stress, there may be periods of up to 3 months of amenorrhea
- Breast tenderness had been resolved, aside from a small 1-2 week episode of tenderness.
After two years:
- She had a period every month that year so far but breast tenderness that was not experienced in the previous year was starting to return.
- Upon examination there appeared to be a left short leg category one, transverse process sensitivity, lumbar rotation, and some adrenal reflex activity was noted. These were adjusted for.
Overall, it appeared that the acupuncture care with CMRT made a real difference for her menstrual abnormality and dysregulation. While the usual case report limitations apply and more research is required before we can generalise, it is an interesting case that shows can be a very real benefit in talking to your chiropractor about more than just your back and neck pain.
- Benner CD, Blum C. CMRT and acupuncture in the treatment of dysmenorrhea (oligomenorhea)[Case Report]. Asia-Pac Chiropr J. 2021;1.3:Online only. URL apcj.net/benner-and-blum-the-treatment-of-dysmenorrhea/