Period pains or primary dysmenorrhoea

Image: Woman in pain

The following article appeared in the Times newspaper on 26 August 2006:

Health alternatives

It works for me: McTimoney chiropractic

A therapy for backache also did the trick for one woman’s period pains, says Emma Mahony

“There was no question about whether I could go to work. The pain was so great that I had to take to my bed,” says Claire Beever, 31, nursing two-week-old baby Jack on her lap. To hear her speak you would think that she was describing a difficult labour and birth, not the monthly occurrence of her period. But for Beever, a primary school teacher from Bishopstone, in Buckinghamshire, her periods had become the bane of her life.
Like many women with this condition in its chronic form (known as primary dysmenorrhoea), she had been to see her GP many times. Primary dysmenorrhoea is defined medically as a pain associated with ovulatory cycles, and doctors usually offer two forms of treatment: anti-inflammatory drugs such as ibuprofen, or oral contraceptive pills to prevent menstrual pain and cramps by suppressing ovulation. Beever had tried every type of prescription painkiller to no effect, but was reluctant to take oral contraceptives.

She also suffered from lower back pain, caused, she thought, by spending so much time in the saddle as a competitive horserider. She had started riding at 11 and had had many falls over the years, but it wasn’t until she was talking to a fellow horse-rider about her back two years ago that she heard of the alternative therapy McTimoney chiropractic. “What attracted me to the treatment was that it was described as being a ‘gentle’ way of realigning the back.”

Despite its gentleness, it can leave patients feeling surprisingly tired and sore the next day, and Beever was no exception.

McTimoney chiropractic differs from other types of chiropractic treatment because of its whole-body philosophy, maintaining that problems in one area may be caused by something elsewhere in the nervous system. The belief is that aligning the vertebrae correctly through manipulation will help the central nervous system to function properly and the body to restore itself to good health. As Anne Yorke, a spokeswoman for the McTimoney Chiropractic Association, says: “It is a bit like tuning a radio. In between the stations you still get noise but it is full of interference. Verterbral misalignment can compress, impinge or stretch nerve endings, resulting in tingling, numbness, restricted mobility or pain elsewhere in the body.”

Julia Sayers, a McTimoney chiropractor from Kings Langley, in Hertfordshire, saw Beever for the first time in 2004 and asked about her menstrual history. Sayers had recently done a review of chiropractic treatment for period pain, looking at evidence from studies that had been carried out nationwide and in particular cases that may have been caused by mechanical misalignment in the lumbar and sacral spine.

Lying face down on the practitioner’s bed, with her back exposed through a gown, Beever remembers feeling light brushing taps on her back accompanied by a clapping sound. Sayers was realigning Beever’s pelvis, which she claims she could feel was out of alignment, and working on her spinal mobility to ease the back pain. After what felt like a pleasurable hour, Beever signed up for three more weekly sessions.

“After my first treatment, I thought that hasn’t done any good,” Beever recalls. “But the next day I felt stiff, heavy and tired, as though I was coming down with flu.” She took Sayers’s advice to rest for 24 hours, and to drink plenty of fluids. Then, a week later, Beever felt as if a miracle had occurred. Her period fell between the second and third McTimoney session and for the first time in 15 years she felt no pain. “It was so dramatic to move from that much pain to nothing at all,” says Beever.

Since then she has had no problems with period pain, her back pain is better and she continues to go for “maintenance” treatments at least twice a year to keep problems at bay.

Sayers was equally pleased. “When you consider that up to 25 per cent of period pain sufferers find no relief from painkillers or contraceptives, you have to believe that more can be done,” she says.

WHAT IS IT?

McTimoney is a gentle, whole-body method of chiropractic, where gentle, fast, precise adjustments are performed to help realign the individual bones of the skeleton. The realignment prevents blockages, or “interference”, in the nervous system and helps the body to rebalance itself. Named after its originator John McTimoney, it is the second largest professional chiropractic association in the UK and Europe, growing by about 150,000 new patients a year. It requires a five-year course to practise.

Suitable for: For anyone from newborn babies to pregnant women and older people. As well as pain from misalignment in the spine and neck, it also claims to help headaches, back, neck and joint pain, irritable bowel syndrome, menstrual pain, dental pain and poor mobility or circulation.

Contact: McTimoney Chiropractic Association; 01491 829211, www. mctimoney-chiropractic.org. For McTimoney chiropractor David Hallam 01733 750893.

WHAT’S THE EVIDENCE? DR TOBY MURCOTT

Does McTimoney chiropractic alleviate period pain? There are many reports from women that chiropractic treatment can ease painful periods; Claire Beever’s experience is a good example of this. So far, though, clinical trials have failed to show that chiropractic is better than a sham, or placebo, treatment, though it may be better than no treatment at all. The internationally respected Cochrane Centre examined the research this year and concluded that there is no evidence that chiropractic manipulation relieves dysmenorrhoea.

How could chiropractic have an effect? The pain of primary dysmenorrhoea comes from cramping in the uterus owing to a temporary lack of blood flow caused by prostaglandin hormones. The nerves that carry this pain signal to the brain enter the spinal cord in the lower back. Nick Panay, the consultant gynaecologist at Queen Charlotte’s and Chelsea, and Chelsea and Westminster Hospitals speculates that manipulation in this region might affect how the pain is perceived or may improve the uterine blood supply but emphasises that there is little direct evidence for this so far.

What else might help take away the pain? One significant step that normally stops painful periods is, according to Panay, to have a baby. In addition, primary dysmenorrhoea normally fades with time and rarely affects women beyond their twenties. Panay says that there are a number of ways of dealing with painful periods. Non-steroidal anti-inflammatory painkillers such as ibuprofen can be effective, and stronger analgesics are available. The other approach is to use a hormone therapy to reduce or stop the periods — such as the Pill.

Is chiropractic harmful? With so little research, it’s impossible to give a clear answer. The Cochrane review concluded that there is no greater risk of adverse effects with chiropractic than with sham manipulation.

Toby Murcott is a former BBC science correspondent