Chiropractic, Women's Health, and PMS

Premenstrual Syndrome, or PMS, is often associated with a wide variety of symptoms that present in a female 5-12 days prior to her menstrual cycle. These symptoms can be physical and/or emotional in nature, and often improve once menstruation begins. In severe cases, PMS can be classified as Premenstrual Dysphoric Disorder (PMDD). These chronic symptoms disable the woman from accomplishing everyday tasks. It is estimated that over 80% of all women have experienced PMS or PMDD symptoms in their life.

PMS often includes many different physical and emotional symptoms. Below are examples of the many complaints and symptoms associated with PMS.

Physical symptoms include: fatigue, insomnia, changes in libido, acne, hives, cramps, bloating, weight gain, headaches, breast tenderness, swelling in the hands and feet, flu-like symptoms (sore throat, sinus problems, and mild fever), heart palpitation, nausea, dizziness, and fainting.

Emotional symptoms include: mood swings, irritability, depression, anxiety, confusion, forgetfulness, emotional eating, food cravings (salt, sweet, spices, alcohol, etc), anger, short tempered, frustrated, "emotional rollercoaster," and loss of sex drive.

According to the American Chiropractic Association, chiropractic is "a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health." The word chiropractic comes from the Greek words "chiro" meaning "hand" and "praktikós" meaning "concerned with, or done by." Most chiropractic procedures consist of manual therapy, whether from exercises, ultrasound, adjustments (manipulation), massage, etc. Chiropractic doctors have many specialties, and techniques that offer a wide variety of applications to these therapies. Based on the patient's preference, patient's needs, doctor's preference, philosophy, and schooling depends on which therapies will be used.

Doctors of Chiropractic have been trained in the examination, diagnosis and treatment of their patients. In most states, chiropractors are considered primary care physicians, are able to accept insurance, can send for diagnostic tests and recommend nutritional/herbal supplementation. In a few areas, chiropractors can perform minor surgery, prescribe medications, deliver babies, and have hospital privileges.

This is actually a very tough question to answer because it depends largely on two things: 1.) State laws where the chiropractor is located, and 2.) The chiropractor's personal philosophy. In most states, chiropractors are able to treat any neuromusculoskeletal condition (neuro = nerve, musculo = muscle, skeletal = bone) in any part of the body, although some states are more restrictive than others. Many chiropractors also have extensive knowledge in nutrition, pediatrics, physiotherapeutic modalities, exercise rehabilitation, and neurology. Chiropractic philosophy is the second major factor in determining what chiropractors treat. Originally, chiropractic adjustments were given to reduce the pressure on a nerve from a bone being out of place (an example often used is a water hose with someone crimping it, not allowing water to flow through properly). Throughout the years of chiropractic, not everyone has agreed with this principle and now some chiropractors only focus on the biomechanics of posture and restricted motion, disregarding a potential effect on the nerve being "pressed." Due to controversial philosophy, some chiropractors only see patients with neck pain, back pain, and headaches while others believe they can create a positive change in the body no matter the condition as long as they can remove or reduce the interference from the nerve being affected.

It is well understood that nerves come out between the vertebrae of the human spine, and then branch off to perform various functions. Different branches of these nerves will communicate with different areas of the body. The nerves that come out of the lower portions of the back (lumbar and sacral nerves) form a web of connections known as the lumbosacral plexus.

Chiropractors evaluate the biomechanics and neurological status of the lumbar and sacral area through many of the following techniques: static palpation, motion palpation, orthopedic tests, muscle strength tests, leg length differences, deep tendon reflexes, sensation testing, patient history, etc. Some chiropractors will also request an x-ray (or other advanced imaging such as CT scans, MRIs, etc.) of the affected area to rule out underline pathological causes to the positive findings they encounter.

After the examination, if the patient's symptoms are within the scope of practice of the doctor, the doctor of chiropractic will begin therapeutic procedures to reduce the symptoms of the area, and attempt to normalize the biomechanical and neurological integrity of the affected joints and nerves. This often includes gentle chiropractic adjustments (manipulation) to the restricted spinal vertebrae, and can include ice/heat packs, ultrasound, massage, electrical stimulation, low level light (laser) therapy and traction. As the patient improves, most doctors will begin to transition the patients into active rehabilitation to support the area, in order to ensure strength and stability to the area. Nutritional supplementation, diet modification, and additional exercises are usually discussed as well as the patient is progressing through the treatment plan.

Research from the Journal of Manipulative and Physiological Therapeutics (May 1999) indicates that women with PMS symptoms experience significantly more muscle tenderness in the low back, muscle weakness, and positive orthopedic findings of the low back. The report concluded, "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." Patients and chiropractors often report a decline in PMS symptoms including back pain, bloating, cramping, and loss of energy.

Further studies are needed to further correlate the association between chiropractic as an alternative treatment to be used with women experiencing PMS. Even with the lack of peer reviewed research, many women and doctors attribute the reduction of their PMS symptoms to the assistance their chiropractor provided.  Have further questions and PMS and chiropractic?  Contact Dr. Chase Hayden to schedule a time to discuss your concerns with him by clicking HERE.