Efficacy of Physiotherapy Treatment in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis

Remedios López-Liria, Lucía Torres-Álamo, Francisco A Vega-Ramírez, Amelia V García-Luengo, José M Aguilar-Parra, Rubén Trigueros-Ramos, Patricia Rocamora-Pérez, Remedios López-Liria, Lucía Torres-Álamo, Francisco A Vega-Ramírez, Amelia V García-Luengo, José M Aguilar-Parra, Rubén Trigueros-Ramos, Patricia Rocamora-Pérez

Abstract

Primary dysmenorrhea (PD) refers to painful cramps before and/or during menstruation. There is a need for emphasis on alternative methods of conservative treatment, so as to reduce the dependence on drugs for alleviating the symptoms. The aim was to find out the effectiveness of some physiotherapy techniques in the treatment of PD. A systematic review and meta-analysis was conducted according to PRISMA standards. The descriptors were "dysmenorrhea", "physical the-rapy", "physiotherapy", and "manual therapy". The search was performed in five databases: Scopus, PubMed, PEDro, Web of Science, and Medline, in February 2021. The inclusion criteria were randomized controlled trials over the last six years. Articles not related to the treatment of PD or using pharmacology as the main treatment were excluded. Nine articles met the objectives and criteria, with a total of 692 participants. The most used scale to measure pain was the VAS (visual analogue scale). The main techniques were isometric exercises, massage therapy, yoga, electrotherapy, connective tissue manipulation, stretching, kinesio tape, progressive relaxation exercises and aerobic dance. Meta-analysis shows benefits of physiotherapy treatment for pain relief compared with no intervention or placebo (MD: -1.13, 95% CI: -1.61 to -0.64, I2: 88%). The current low-quality evidence suggests that physiotherapy may provide a clinically significant reduction in menstrual pain intensity. Given the overall health benefits of physiotherapy and the low risk of side effects reported, women may consider using it, either alone or in conjunction with other therapeutic modalities.

Keywords: electrotherapy; manual therapy; pain; physical therapy; primary dysmenorrhea.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Isometric Exercises [35].
Figure A2
Figure A2
Yoga positions for dysmenorrhea [37].
Figure A3
Figure A3
Stretching Exercises [40].
Figure 1
Figure 1
Flowchart of articles selection process.
Figure 2
Figure 2
Summary of Risk of Bias in included studies.
Figure 3
Figure 3
Pooled MD (95% CI) of effect of physiotherapy in pain relief.

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