Introduction A 31-year-old female patient presented initially to this office for low back and foot pain 5 years prior and sought preventative wellness care and strategies. Approximately 5-years into care, February 2008, the patient discussed the possibility of utilizing acupuncture to help her cope with an irregular menstrual cycle (Oligomenorrhea), having only light periods (1-2 days) 2-3 times a year for over 10-years or more.
Purpose/Aim An interdisciplinary treatment plan that can vary to treat patients with the multi-causal nature of female related menstrual type disorders with low back pain may be needed for a specific subset of patient. With the risk benefit ratios of pharmaceutical interventions any attempt to utilize alternative type methods that offer low risk and some benefit should be investigated.
Materials and Methods The patient was assessed and treated using sacro occipital technique (SOT) chiropractic, chiropractic manipulative reflex technique, and acupuncture protocols to evaluate and treat both low back pain and any related viscerosomatic disorders possibly affecting her menstrual cycle.
Results Following one-year of integrating SOT chiropractic CMRT procedures for liver (T8), adrenals (T9), and acupuncture her low back pain had been eliminated along with an increased ability to function and her menstrual cycle has been regulated with periods of monthly cycling and with only 3 months of amenorrhea one-time during a time of high stress and anxiety.
Relevance Since some studies have found a relationship between dysmenorrhea and lumbopelvic pain1 and both chiropractic2 and acupuncture3 have been found helpful for some of these related conditions, interdisciplinary care may be an important part of the treatment for patients with these complex presentations.
Conclusions The chronicity of the patient symptoms, over 10 years, and the temporal relationship between treatment and response to care is compelling. Further research is indicated to determine what subset of patients with dysmenorrhea and lumbopelvic pain is best suited for chiropractic and acupuncture intergrated care
Discussion It is also of interest that the patient was receiving chiropractic care on an ongoing preventative basis but not until the treatment changed to include CMRT and acupuncture was there a consistent improvment in her lumbopelvic pain and viscerosomatic symptomatolgy.
Implications Complex unresponsive lumbopelvic pain presentations, with seemingly unrelated co-morbidities of viscerosomatic origin may be worthy of consideration, along with integrated interdisciplinary care.
References:
1. Bull PW, Genders WG, Hopkins SS, Lean EK. Dysmenorrhea and pelvic dysfunction: A possible clinical relationship. Chiropr J Aust. 2003 Mar;33(1):23-9.
2. Kokjohn K, Schmid DM, Triano JJ, Brennan PC. The effect of spinal manipulation on pain and prostaglandin levels in women with primary dysmenorrhea. J Manipulative Physiol Ther. 1992 Jun;15(5):279-85.
3. Witt CM, Reinhold T, Brinkhaus B, Roll S, Jena S, Willich SN. Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. Am J Obstet Gynecol. 2008 Feb;198(2):166.e1-8.