Gynecological Conditions

Gynecological Conditions

Masarsky C. and Weber M. (Neurological Fitness Vol. 2, No. 1 Oct. 1992) state: “While a medical examination to rule out serious underlying pathology is always a good idea, researchers have suggested that chiropractic care might be a viable alternative for women suffering from menstrual pain and discomfort. This would be especially true for women who cannot or do not wish to take anti-inflammatory drugs or oral contraceptives.”

Neurological Pelvic Pain. Molina N. Dynamic Chiropractic Jan 29th, 2001 p. 28, 40.

This is the case of a 45 year old woman who had been suffering from constant pain in the lower back and the right lower quandrant of the abdomen. She had initially gone to her OB/GYN. She was first given antibiotics with little improvement.

A total abdominal hysterectomy was then performed (including the tubes and the ovaries). Her pain was gone after the surgery, for about 3 weeks. Then it returned. Chiropractic examination revealed disc herniation at L1-L2 and disk bulge at L5-S1. Her neurologist recommended back surgery (laminectomy). Patient refused. After six months chiropractic care, she remains relatively pain free. She could have avoided major surgery if she had seen a chiropractor first.

The types and frequencies of nonmusculoskeletal symptoms reported after chiropractic spinal manipulative therapy. Leboeuf-Yde C, Axen I, Ahlefeldt G, et al.J Manipulative Physiol Ther Nov/Dec 1999:22(9) 559-64.

“How frequently [do] patients report nonmusculoskeletal symptomatic improvements and [what are] the types of such reactions that patients believe to be associated with chiropractic…”

Twenty consecutive patients from 87 Swedish chiropractors answered questionnaires on return visits. A total of 1,504 questionnaires were completed and returned. Twenty-three per cent of patients reported improvement in nonmusculoskeletal symptoms, including:

  • Easier to breathe (98 patients)
  • Improved digestive function (92)
  • Clearer/better/sharper vision (49)
  • Improved circulation (34)
  • Less ringing in the ears (10)
  • Acne/eczema better (8)
  • Dysmenorrhoea better (7)
  • Asthma/allergies better (6)
  • Sense of smell heightened (3)
  • Reduced blood pressure (2)
  • Numbness in tongue gone (1)
  • Hiccups gone (1)
  • Menses function returned (1)
  • Cough disappeared (1)
  • Double vision disappeared (1)
  • Tunnel vision disappeared (1)
  • Less nausea (1)

Dysfunctional uterine bleeding in a woman with concomitant low back pain and lower extremity pain – conservative chiropractic intervention. Stude DE. In: Proceedings of the 1991 International Conference on Spinal Manipulation, FCER; 63-66

This is the case of a patient with dysfunctional uterine bleeding, lower back pain and lower extremity symptoms. The day after a chiropractic adjustment the patient reported improvement in bleeding and musculoskeletal symptoms. By the second adjustment, all symptoms disappeared. Four months later symptoms had not returned and normal menstruation had resumed. One year later, uterine bleeding returned without back or extremity pain. After she received chiropractic adjustments once again the bleeding stopped.

The mechanically induced pelvic pain and organic dysfunction syndrome: an often overlooked cause of bladder, bowel, gynecological, and sexual dysfunction. Browning JE. Journal of the Neuromusculoskeletal System,1996; 4:52-66

The mechanically induced pelvic pain and organic dysfunction (PPOD) syndrome is thought to be caused by subluxations of the lumbar spine affecting lower sacral nerves.

Sufferers with PPOD can have low back pain, bladder, bowel, gynecologic and/or sexual dysfunction.

This is the case of a 29-year old woman with bilateral pelvic and low back pain, inguinal pain, urinary stress incontinence, loss of genital sensitivity, loss of libido and vaginal discharge. A gynecological exam failed to reveal any pathology.

Sacral nerve root involvement, secondary to a L5/S1 disc herniation was found. Under chiropractic care, the patient initially experienced symptoms of pain and paraesthesia of the genitalia which disappeared quickly. Within one week her bladder dysfunction had resolved and the other symptoms were less severe.

After 4 weeks, her other symptoms had completely resolved.

Chiropractic care for women with chronic pelvic pain: a prospective single-group intervention study. Hawk, C, Long C, Azad A.J Manipulative Physiol Ther Vol. 20 No. 2 Jan 1997.

This was a study involving 19 volunteer female subjects (18 completed the study) to assess the role of chiropractic care for women with chronic pelvic pain (CPP)

The mean improvement in the PDI score was 13.0 points; in the VAS it was 4.0 and in the BDI it was 6.1 points. All eight subscales of the Rand-36 Health Survey increased post-intervention, with the largest differences in role function limitations because of physical problems (45.8%), emotional problems (44.4%) and pain (40.6%).

Chiropractic management of a 7-year-old female with recurrent urinary tract infections. Vallone SA. Chiropractic Technique 1998: 10:113-117.

This girl had trauma to the thoracic and lumbar spine and had not responded to homeopathic and antibiotic therapy for two years. The patient received eight chiropractic adjustments over a period of two months with complete resolution of the complaint.

Distractive manipulation protocols in treating the mechanically induced pelvic pain and organic dysfunction patient. Browning JE Chiropractic Technique. 1995; 7:1-11.

From the abstract:

Treatment protocols outlining the application of distractive decompressive manipulation of the lumbar spine in the management of the (mechanically induced pelvic pain and organic dysfunction syndrome) have been developed. Their incorporation requires the identification of patients with symptoms of bladder, bowel, gynecologic, and sexual dysfunction secondary to impairment of lower sacral nerve root function as a result of a mechanical disorder of the low back.

Dysmenorrhoea. To treat or not to treat. Polus, BI, Henry SJ, Walsh MJ. Chiro J Aust 1996; 26:21-4.

This review paper examined a number of studies that have shown a positive correlation between chiropractic intervention and the alleviation of the suffering associated with primary dysmenorrhea.

The effect of spinal manipulation on pain and prostaglandin levels in women with primary dysmenorrhea. Kokjohn J, Schmid DM, Triano JJ, Brennan PCJ Manipulative Physiol Ther, June 1992; 15(5): 279-285.

This was a randomized pilot study of 45 women, age 20-49, who were divided into experimental and control groups. The controls received a "sham" manipulation.

The perception of pain and level of menstrual distress were significantly reduced immediately after spinal manipulation. The symptom improvement of the experimental group was twice as great as the symptom improvement of the control group. These effects were associated with significant decreases in post-manipulative plasma levels for both groups.

Evaluation of the Toftness system of chiropractic adjusting for subjects with chronic back pain, chronic tension headaches, or primary dysmenorrhea. Snyder, BJ, Sanders, GE Chiropractic Technique, 1996;8:3-9.

This is a study of 24 subjects with chronic back pain, 19 subjects with chronic tension headaches and 26 subjects with dysmenorrhea who underwent a series of Toftness adjustments or sham interventions. Toftness adjustments had significant clinical benefit, whereas those receiving sham interventions did not improve

Enuresis, spasmodic dysmenorrhea and gastric discomfort: a vertebral subluxation complex entity. Regan KJ Digest of Chiropractic Economics March/April 1990;32(5):110

Patients suffering from bed-wetting, menstrual cramps and ulcer pains/indigestion were given chiropractic care. MDs performed pap tests, pelvic exams and upper GI studies which were negative for active pathology. One subject did have a true peptic ulcer and demonstrated a desire to go in the study.

“A total of eight subjects in each category were selected and two in each category were not treated (to be used as control studies)….It should be noted here that no one had any low back, dorsal or cervical spine pain prior to being a patient in this program.

“In the dysmenorrhea category, all cases of pelvic pain and severe cramping of the uterus had stopped.” All women experienced three menstrual cycles through the duration of this study. “The bedwetting category demonstrated 50% of the children had stopped bedwetting early in the program, 25% of the children had a 50% reduction in the frequency of occurrences and 25% showed no improvement.

All the patients in the gastric category except one responded to chiropractic care; no one was taken off medication or put on special diet.”

Disorders of the iliopsoas muscle and its role in gynecological diseases. Dobrik I. Journal of Manual Medicine, 1989; 4: 130-133.

This paper discusses how gynecologists and chiropractors should work together for the benefit of the patient.

Effectiveness of spinal manipulative therapy in treatment of primary dysmenorrhea: a pilot study. Thomason PR, Fisher BL et al Journal of Manipulative and Physiological Therapeutics, 1979; 2:140-145.

One group of women received chiropractic adjustments, one group was given sham adjustments and one group was monitored only (control).

24.6% of the subjects demonstrated a vertebral displacement at the first lumbar segment, 45.5% showed it at the second lumbar level, 54.0 % at third lumbar, 63.7% at fourth lumbar, and 63.7% had a fifth lumbar subluxation. Of those who received chiropractic adjustments, 88% reported reduced pain during their menstrual periods while none of the control or sham group did.

A chiropractic approach to the treatment of dysmenorrhea. Liebl NA, Butler LM Journal of Manipulative and Physiological Therapeutics, 1990; 13:101-106.

This is the study of a patient suffering from monthly menstrual cramps since the onset of menses which intensified after the birth of her child, 4 years prior, (eight painful days a month). The patient received 19 adjustments over a two month period, approximately twice per week for the first two months and once a week for the last month. Patient was adjusted in the sacroiliac, upper lumbar, mid-thoracic and upper cervical areas. Some cranial adjusting was done in some sessions.

“The average number of recordings showing pain in the baseline phase was 8 per month compared to an average of 2.25 episodes per month in the treatment phase.” Pain was over 1/3 lessened.

Mechanically induced pelvic pain and organic dysfunction in a patient without low back pain. Browning JE. Journal of Manipulative and Physiological Therapeutics, 1990; 13:406-411.

18 years of organ trouble in the pelvis including diarrhea, pelvic pain, and reduced genital sensitivity resolved within eight weeks of chiropractic care. The patient had undergone numerous medical and surgical procedures: an appendectomy for abdominal pain (appendix was normal), partial hysterectomy and left oophorectomy to resolve pelvic pain and abdominal bleeding, three exploratory bowel surgeries for continuous diarrhea, pain, rectal bleeding and mucous discharge and four bladder surgeries - without resolution.

Patient had reduced genital sensitivity, sexual dysfunction (been unable to experience orgasm), and had pelvic pain during intercourse.

Diagnosis: Central L5 disc herniation.

Complete resolution of symptoms including pelvic pain and diarrhea occurred within eight weeks; genital sensitivity improved and patient was able to achieve orgasm on a regular basis after thirty weeks.

Pelvic pain and organic dysfunction in a patient with low back pain: response to distractive manipulation: a case presentation. Browning J. Journal of Manipulative and Physiological Therapeutics, June 1987; 10(3): 116-121.

Chiropractic may be an effective means of treating pelvic disorders secondary to lower sacral nerve root compression.

The recognition of mechanically induced pelvic pain and organic dysfunction in the low back pain patient. Browning JE Journal of Manipulative and Physiological Therapeutics, Vol. 12 No. 5 Oct, 1991.

Pelvic organic problems responding to manipulative treatment include impairment of bladder, bowel and sexual function.

Uncomplicated mechanically induced pelvic pain and organic dysfunction in low back patients. Browning JE J of the Canadian Chiropractic Association. 1991; 35: 149-155. The first patient was a 29 year old female with back pain radiating into the right leg following a lifting injury. In addition a second lifting injury caused urinary urgency and stress incontinence, loss of genital sensitivity, loss of libido and constant sharp rectal pain. No pelvic abnormality could be found. Within one month of chiropractic care the bladder disturbance and the other pelvic complaints completely cleared up.

Distractive manipulation protocols in treating the mechanically induced pelvic pain and organic dysfunction patient. Browning JE, Chiropractic Technique, Vol. 7, No.1, Feb. 1995.

From the author’s abstract:

The mechanically induced pelvic pain and organic dysfunction syndrome...characterized by various disturbances in pelvic organ function has been successfully managed by chiropractic manipulative procedures...symptoms [include] bladder, bowel, gynecologic, and sexual dysfunction secondary to impairment of lower sacral nerve root function as a result of a mechanical disorder of the low back.

Association between primary dysmenorrhea and pain threshold at the thoracolumbar junction. Hains F, Batt R, Bellis S, Martel J. Proceedings of the 1992 International Conference on Spinal Manipulation, FCER; 106-109.

This study showed a possible correlation between the thoracolumbar junction, spinal irritation and dysmenorrhea using pressure pain threshold algometry.

Dysfunctional uterine bleeding with concomitant low back and lower extremity pain. Stude, DE Journal of Manipulative and Physiological Therapeutics, Vol. 14 No. 8 Oct. 1991.

A temporal relationship between chiropractic care and uterine bleeding in a patient with mild low back and leg pain.

Endometriosis and anterior coccyx: observation of five cases. Robinson and Freedman. Research Forum 1(4) Chiropractic helps endometriosis sufferers.

Painful menstruation with special reference to posture as an etiological factor. Adams TW, Pacific Medicine and Surgery, 1943; 42.

The group suffering from menstrual pain had a much higher incidence of poor posture.

Theoretical considerations to the clinic and therapy of spinal disturbances in gynecology. Dvorak N. Manuelle Medizin, 1973, Heft 1. Five pages.

This is the study of 496 female patients with gynecological problems (inflammation, dysmenorrhea, sacral pain etc.) who underwent chiropractic care. Immediate relief occurred in most cases.

Functional disorders (fixations) of the spine in children. Lewit K. Manuelle Therapie, J.A. Barth, Leipzig, 1973. Chap.2.7. Pp. 50-54.

Functional disorders in children may manifest themselves as sleep disorders, loss of appetite, psychic problems, and dysmenorrhea and may not exist as spinal pain. Studies on healthy children revealed pelvic subluxations in 40% of all school children, cervical fixation in 15.8%. After manipulative treatments, the problems rarely recurred.

Chiropractic adjustment in the management of visceral conditions: a critical appraisal. Jamison JR, McEwen AP, Thomas SJ. J Manipulative Physiol Ther, 1992; 15:171-180.

This was a survey of chiropractors in Australia. More than 50% of the chiropractors stated that asthma responds to chiropractic adjustments; more than 25% felt that chiropractic adjustments could benefit patients with dysmenorrhea, indigestion, constipation, migraine and sinusitis.

Investigation of the effect of chiropractic adjustments on a specific gynecological symptom: dysmenorrhea. Arnold-Frochot S. J Aust Chiro Assoc, 1981; 10:14-16.

The authors identify chronic low back pain and abdominal pain as typifying dysmenorrheal. They discuss five patients (ages 18 to 23) suffering from this condition. Two patients responded “almost immediately” and “were almost completely relieved of their menstrual pain.” Two others felt no benefit and the fifth had “some relief after intra-pelvic work was performed in order to reposition the uterus.”

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