Low Back and Dysmenorrhea – Are They Related?

Dysmenorrhea, also known as painful periods, is a common gynecological condition that affects up to 70% of menstruating women. About 15% of individuals with the condition report that it significantly interferes with their activities of daily living (ADLs) and in some cases, results in absence from school and/or work. Studies have found that dysmenorrhea is related to early menarche (the onset of menstruation), nulliparity (not having children), and stress. But is it possible there’s an anatomical component to the condition?

The lumbar spine, or low back, consists of five vertebrae that rest on top of the sacrum, or tail bone, which is wedged between the “wings” of the pelvis (the ilia) making up the sacroiliac joints (SIJs). This close anatomical relationship with the pelvic organs suggests that the musculoskeletal dysfunction may play some role in dysmenorrhea. But is this truly an important relationship and if so, can spinal manipulation to the low back and pelvis/SIJs help reduce the pain associated with dysmenorrhea?

One study looked at the relationship between pelvic alignment and dysmenorrhea in 102 females divided into groups of those with and those without the condition. The researchers observed there were differences in pelvic alignment between members of both groups.

Another group studied the lumbo-pelvic alignment and abdominal muscle thickness in 28 women with primary dysmenorrhea and 22 women without the condition and found greater misalignment and smaller diameter abdominal muscles in the dysmenorrhea group.

To determine if there is a change in pain perception after pelvis manipulation in women with primary dysmenorrhea, a randomized controlled trial of 40 women (20 in two different groups) received a “global pelvic manipulation” (GPM) while the other group received a sham or placebo intervention. The participants in the GPM treatment group reported significant improvements in overall pain and sensitivity when compared with the sham treatment group, supporting manipulation as an effective tool in the management of dysmenorrhea.

Though further research is warranted, this study shows there is scientific support for the use of spinal adjustments in women suffering from dysmenorrhea. Therefore, chiropractic may offer an effective, safe, and often fast remedy for those who choose to not risk the side effects of various medications commonly used to treat dysmenorrhea.