Premenstrual Syndrome:

A randomized, placebo-controlled clinical trial on the efficacy of chiropractic therapy on premenstrual syndrome

OBJECTIVE

To evaluate the efficacy of chiropractic therapy on the treatment of symptoms associated with premenstrual syndrome.

DESIGN

A prospective, randomized, placebo-controlled, crossover clinical trial.

SETTING

Multicenter private clinics.

SUBJECTS

Twenty-five subjects with diagnosed premenstrual syndrome (with a Moos premenstrual syndrome questionnaire plus daily symptom monitoring).

INTERVENTION

After randomization, 16 of the subjects received high-velocity, low-amplitude spinal manipulation plus soft tissue therapy 2 to 3 times in the week before menses for at least 3 cycles. The remaining 9 subjects received a placebo treatment with a spring-loaded adjusting instrument wound down for minimum force. After a 1-cycle washout, the 2 groups changed over.

OUTCOME MEASURE

Daily rating of symptom level, comparing total scores for premenstrual week with baseline for treatment and placebo phases.

DATA ANALYSIS

The data were analyzed with paired Student t tests and Wilcoxon signed rank tests, with the statistical significance set at P < .05.

RESULTS

There was a significant decrease in scores after treatment compared with baseline scores (P = .00001) and a statistically significant decrease in scores for the treatment phase compared with the placebo (P = .006). For group 1 (n = 16), there was a significant decrease in scores after treatment compared with baseline scores (P = .0001) and a statistically significant decrease in scores for the treatment phase compared with the placebo (P = .041). For group 2 (n = 9), there was a significant decrease in scores during treatment compared with the baseline (P = .01); however, there was no difference at the P = .05 level between treatment and placebo scores.

CONCLUSIONS

Within the limitations of the study, the results support the hypothesis that the symptoms associated with PMS can generally be reduced by chiropractic treatment consisting of adjustments and soft-tissue therapy. However, the role of a placebo effect needs further elucidation, given that the group receiving the placebo first, although improving over the baseline, showed no further improvement when they had actual treatment.

The frequency of positive common spinal clinical examination findings in a sample of premenstrual syndrome sufferers

OBJECTIVE

As part of a randomized clinical trial to determine the efficacy of chiropractic therapy on premenstrual syndrome (PMS), subjects were evaluated for initial underlying spinal dysfunction.

SUBJECTS

Fifty-four subjects with diagnosed PMS (using a Moos PMS questionnaire plus daily symptom monitoring) and 30 subjects with no diagnosable PMS were recruited by newspaper advertising and referrals.

DESIGN

All subjects underwent a full history and physical and chiropractic examination carried out by 1 of 2 fully qualified and registered chiropractors, each with a minimum of 10 years experience. The results of the assessment for the PMS group were compared with those of the non-PMS group.

SETTING

RMIT teaching clinics.

DATA ANALYSIS

The data collected were entered into a spread sheet and contingency tables were created. The data were analyzed by use of chi-squared tests, with the statistical significance being set at P < .05.

RESULTS

The PMS group had a higher percentage of positive responses for each of 12 measured spinal dysfunction indexes except for range of motion of the low back. The indexes where the increase was statistically significant (P < .05) were cervical, thoracic, and low back tenderness, low back orthopedic testing, low back muscle weakness, and the neck disability index. An average of 5.4 of the 12 indexes were positive for the PMS group compared with 3.0 for the non-PMS group.

CONCLUSIONS

A relatively high incidence of spinal dysfunction exists in PMS sufferers compared with a comparable group of non-PMS sufferers. This is suggestive that spinal dysfunction could be a causative factor in PMS and that chiropractic manipulative therapy may offer an alternative therapeutic approach for PMS sufferers.