For many women, menstrual discomfort is treated as an unfortunate but normal part of life, yet chiropractors know that while this might be common, it certainly isn’t normal. For a significant number of women, menstrual symptoms are far more than a mild inconvenience. Severe cramping, headaches, fatigue, and heavy bleeding can disrupt daily functioning, interfere with work or study, and diminish quality of life. Yet despite the fact that severe, painful menstruation (dysmenorrhea) is so prevalent, awareness and research on the condition have still failed to solve the problem for so many sufferers.
A recent case report published in the Journal of Contemporary Chiropractic explored an interesting clinical question: can chiropractic care help women experiencing severe menstrual symptoms? The case examined the outcomes of care using the Logan Basic Technique, a gentle chiropractic approach that focuses on the sacrum and pelvic structures. The results provide an intriguing glimpse into how chiropractic care may influence conditions that extend beyond typical musculoskeletal complaints. [1]
Its not the first case report that has covered improvements in dysmenorrhea or reproductive function, but it is a timely reminder that we still have not seen larger studies on this issue in the chiropractic context, and thus, many people in the grip of this condition may not know that chiropractic care may help.
Dysmenorrhea, is extremely common. Research suggests that between 50% and 90% of women of reproductive age experience menstrual pain, sometimes severe enough to interfere with normal life. [1] Given it is thought that 50% of the population is female, the personal, medical and economic cost is immense, and yet largely suffered in silence.
Symptoms often include lower abdominal pain, but the experience is rarely limited to the pelvis. Many women report:
- lower back pain
- headaches or migraines
- nausea or vomiting
- fatigue
- pain radiating into the legs
These symptoms can affect school attendance, workplace productivity, mental wellbeing, and overall quality of life. Despite this, many women simply accept the symptoms as normal and never seek professional advice. Conventional management often includes medications such as non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal contraceptives. Despite the widespread use of NSAIDS or hormonal contraceptives, they are not without their side effects and risks. Some women do explore complementary approaches, including physiotherapy, acupuncture, exercise, and spinal manipulation, but awareness of the possibilities of chiropractic care may still be lacking.
The new case report
The case report focused on a 28-year-old woman who sought chiropractic care at an academic clinic. Initially, she presented for routine musculoskeletal care related to the stresses of studying. Over time, as trust developed with the student providing care, the patient began discussing another long-standing issue: severe menstrual symptoms.
For more than twelve years, her menstrual cycles had been debilitating. Each month she experienced severe cramping rated 10 out of 10 on a pain scale, migraines during menstruation and heavy bleeding lasting about nine days. These symptoms had a profound effect on her quality of life, including her activities of daily living. However, they had not previously been a focus of her chiropractic care.
Before exploring alternative approaches, the patient had already received chiropractic treatment for more than a year. Her care primarily involved high-velocity, low-amplitude spinal adjustments delivered with a drop-table technique. These adjustments focused on correcting dysfunctions in the lumbar spine and pelvis.
While this care helped address some musculoskeletal complaints, it did not significantly improve her menstrual symptoms. The severe cramps, headaches, and prolonged bleeding continued each month. At that point, the patient expressed interest in trying a different chiropractic approach known as the Logan Basic Technique.
The Logan Technique was developed by chiropractor Hugh Logan in the 1920s. It is considered one of the gentlest chiropractic methods. [1]
Rather than high-velocity adjustments, Logan Technique uses very light and sustained pressure applied to the sacrotuberous ligament, located near the sacrum at the base of the spine. The goal is to encourage relaxation of the surrounding ligaments and muscles, allowing the sacrum to gradually return toward a more balanced position.
The sacrum and pelvis play an important role in supporting the organs of the reproductive system, including the uterus. Because nerves that influence pelvic organs travel through the lumbosacral region of the spine, some chiropractors theorise that improving function in this area may influence symptoms related to menstruation.
Another practical advantage is the technique’s gentle nature. For patients experiencing pelvic or abdominal pain, lighter approaches may be more comfortable than other adjustments.
Early Improvements
One of the most striking aspects of the case was how quickly some changes appeared. At the beginning of care, the patient’s menstrual symptom score was 76.6 out of 100, placing her firmly within the severe range. After just two visits using Logan Technique, the patient reported noticeable improvement in her menstrual symptoms. Over the following weeks, progress continued.
Within two months, her score dropped to 33, indicating low-intensity pain rather than severe symptoms. The improvement was not only numerical. According to the report, the patient became emotional during follow-up visits, explaining that her “life had changed” since beginning this approach to care. Her menstrual cramps were less intense, and the overall burden of symptoms had significantly decreased.
Partway through the care plan, the patient went on vacation and missed a week of treatment. During the next menstrual cycle, her symptoms returned somewhat. However, they were still less severe than before starting Logan Technique care.
This observation raises an interesting possibility. Consistent care may have contributed to maintaining the improvements, suggesting that ongoing management might be necessary for sustained benefits.
Of course, as with any single case report, it is not possible to determine cause and effect with certainty. Nevertheless, the pattern of improvement offers a valuable clinical observation, and it is one shared by other case reports wherein a lapse in care increased symptoms until care resumed. This phenomenon has not been examined in larger studies, and begs the question: what is the ideal care frequency for chronic conditions? It suggests that wellness or maintenance care may be more important than we think, and that stabilising symptoms and then bidding patients farewell until their next flare up may be a great disservice to our tribe.
What Might Explain the Results?
Although case reports cannot establish definitive mechanisms, several possible explanations are worth considering. The main hypothesis is of course regarding optimal neurological function affecting the uterus and pelvic organs, but also the potential influence of chiropractic on autonomic nervous system function that then affects end organs and hormones.
Second, many women with dysmenorrhea experience concurrent lower back pain and pelvic discomfort. Addressing spinal or pelvic dysfunction may therefore reduce the musculoskeletal component of the pain experience.
Supporting this idea, earlier research has found that treatment of motion restrictions in the lumbosacral spine may reduce menstrual pain in some patients. [2] Finally, gentle techniques like Logan Basic may influence muscle tension and ligament balance in the pelvic region, potentially altering mechanical stresses within the pelvis. These possibilities remain areas for further investigation.
The case reminds practitioners to remain curious. When conventional approaches do not produce the desired results, exploring different techniques or perspectives may reveal new possibilities. In this instance, a gentle sacral-focused technique appeared to produce improvements where other methods had not.
Menstrual pain is often dismissed as inevitable. Yet for many women, it represents a significant health burden. This case reminds us that conversations about health do not always begin where we expect. A patient seeking help for study-related neck or back discomfort may also be dealing with other challenges that affect daily life. Chiropractors, by virtue of their focus on the nervous system and spinal function, are in a unique position to explore these connections.
Sometimes the results may surprise us.
References
Wells, B., Klaus, L., & Woosley, V. (2025). Addressing menstrual symptoms with Logan Technique: A case report. Journal of Contemporary Chiropractic. (journal.parker.edu)
Holtzman, D. A., Petrocco-Napuli, K., & Burke, J. R. (2008). Prospective case series on the effects of lumbosacral manipulation in the treatment of primary dysmenorrhea. Journal of Manipulative and Physiological Therapeutics. (PubMed)
