Objective: The purpose of this case study was to report the effects of multimodal therapy as an adjunct to oral contraceptives on pain and menstrual symptoms in a patient with primary dysmenorrhea.
Clinical Features: A 27-year old nulligravid and nulliparous woman presented with low back pain, thigh pain, and menstrual symptoms associated with primary dysmenorrhea. Multimodal therapies (spinal manipulation, clinic-based transcutaneous electrical nerve stimulation, and heat applied at home) were delivered over 3 menstrual cycles. Outcome measures included pain (visual analogue scale) and menstrual symptoms (Menstrual Distress Questionnaire) from baseline to follow-up. She continued to take her oral contraceptives throughout the study period.
Intervention and Outcome: For both low back and thigh pain, the patient reported clinically important differences in average pain and worst pain after 2 and 3 months from baseline. There were no clinically important differences in current pain, best pain, or menstrual symptoms at follow-up. No adverse events were reported.
Conclusion: Some of this patient’s dysmenorrhea symptoms responded favorably to multimodal therapy over 5 months. The authors observed important short-term reductions in low back and thigh pain (average and worst pain intensity) during care.
Author keywords: Dysmenorrhea; Manipulation, Spinal; Manipulation, Chiropractic; Transcutaneous Electric Nerve Stimulation; Combined Modality Therapy
Author affiiations: JJW, SM: Division of Graduate Studies, Canadian Memorial Chiropractic College Toronto, Ontario, Canada; ML: Private Practice, Orillia, Ontario, Canada
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