Osteopathischer Behandlungseffekt auf Dysmenorrhö

In: Manuelle Medizin · 2013 · vol. 51(4) , pp. 325–332 · doi:10.1007/s00337-013-1047-3 · W43783634
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Osteopathic treatment for dysmenorrhea reduced menstrual pelvic pain significantly over three cycles by potentially resolving visceral adhesions.

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This study investigated whether osteopathic treatment could alleviate menstrual pelvic pain by addressing presumed visceral adhesions in twenty patients with primary or secondary dysmenorrhea. Researchers administered four sessions of standardized osteopathic techniques and recorded pain intensity using a visual analog scale over three consecutive menstrual cycles. The results demonstrated that both primary and secondary dysmenorrhea symptoms decreased significantly and remained reduced following the intervention, suggesting that functional disorders like adhesions contribute to cramp-like pain. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Material

und Methode Untersucht wurde der Effekt von 4 OB (n = 20), jeweils bestehend aus 5 standardisierten Techniken. Die Messung des Zielparameters (Intensität der Unterbauchschmerzen) erfolgte mithilfe einer visuellen Analogskala und wurde über 3 Menstruationszyklen dokumentiert. Ergebnisse Die Unterbauchschmerzen sowohl der primären als auch der sekundären Dysmenorrhö wurden im Verlauf der osteopathischen Behandlung vergleichbar signifikant und auch anhaltend geringer. Schlussfolgerung Der positive Effekt von OB legt die Vermutung nahe, dass viszerale Adhäsionen bei der Entstehung menstrualer Unterbauchkrämpfe eine Rolle spielen. So könnte die Osteopathie eine Alternative zur medikamentösen Behandlung darstellen.

Abstract

Background Dysmenorrhea represents a chronic disease with a high prevalence. Primary and secondary dysmenorrhea differ with respect to different origins but the main symptom of cramp-like pelvic pain is common to both types of dysmenorrhea. Drugs play an important role in the therapy of dysmenorrhea and are effective in 70 % but are not effective in the long-term and show adverse side effects. This study presents unanswered questions about the pathophysiological background. It is presumed that vertebral dysfunction or visceral adhesions are cofactors of dysmenorrhea and play a role in menstrual pain with neurovascular and mechanical impact. The objective of the study was the relief of menstrual pelvic pain by osteopathic treatment of visceral adhesions.

Materials and methods

This study (n = 20) considered the effects of four forms of osteopathic treatment each consisting of five standardized osteopathic techniques. The elicitation of the main parameter (intensity of pelvic pain) was given on a visual analog scale and documented over three menstrual cycles.

Results

Menstrual pelvic pain of primary and secondary dysmenorrhea decreased significantly over three menstrual cycles after osteopathic treatment.

Conclusions

Functional diseases, such as visceral adhesions play an important role in dysmenorrhea as an origin of lower abdominal cramp. Due to the positive effect of osteopathic treatment it is presumed to be an alternative treatment to drug therapy. Similar content being viewed by others Literatur Berg F van den, Cabri J (2011) Angewandete Physiologie 1. Das Bindegewebe des Bewegungsapparates verstehen und beeinflussen, 3. Aufl. Thieme, Stuttgart Clausen N, Wolloscheck T, Konerding MA (2008) How to optimize autonomic nerve preservation in total mesorectal excision: clinical topography and morphology of pelvic nerves and fasciae. World J Surg 32(8):1768–1775 Field T, Diego M, Hernandez-Reif M (2010) Moderate pressure is essential for massage therapy effects. Int J Neurosci 120(5):381–385 Hammoud A, Gago LA, Diamond MP (2004) Adhesions in patients with chronic pelvic pain: a role for adhesiolysis? Fertil Steril 82(6):1483–1491 Hao M, Zhao WH, Wang YH (2009) Correlation between pelvic adhesions and pain symptoms of endometriosis. Zhonghua Fu Chan Ke Za Zhi 44(5):333–336 Hundscheid HW, Pepels MJ, Engels LG, Loffeld RJ (2007) Treatment of irritable bowel syndrome with osteopathy: results of a randomized controlled pilot study. J Gastroenterol Hepatol 22(9):1394–1398 Kolmorgen K, Haußwald HR, Havemann O (1976) Chronische Unterbauchbeschwerden der Frau – eine postlaparoskopische Analyse. Zentralbl Gynakol 98:1434–1440 Korr IM (1979) The spinal cord as organizer of disease processes. III. Hyperactivity of sympathetic innervation as a common factor in disease. J Am Osteopath Assoc 79(4):232–237 Latthe PM, Champaneria R, Khan KS (2011) Dysmenorrhoea. Clin Evid (online) Marjoribanks J, Proctor M, Farquhar C, Derks RS (2010) Nonsteroidal anti-inflammatory drugs for Dysmenorrhoea. Cochrane Database Syst Rev 1:CD001751 Nascu PC, Vilos GA, Ettler HC et al (2006) Histopathologic findings on uterosacral ligaments in women with chronic pelvic pain and visually normal pelvis at laparoscopy. physio. J Minim Invasive Gynecol 13(3):201–204 Rapkin AJ (1986) Adhesions and pelvic pain: a retrospective study. Obstet Gynecol 68(1):13–15 Willard FH, Schuenke MD (2013) The neuroanatomy of female pelvic pain. In: Bailey A, Bernstein C (eds) Pain in women. Springer, Berlin Heidelberg New York Einhaltung der ethischen Richtlinien Interessenkonflikt. Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht. Alle angewandten Verfahren stehen im Einklang mit den ethischen Normen der verantwortlichen Kommission für Forschung am Menschen (institutionell und national) und mit der Deklaration von Helsinki von 1975 in der revidierten Fassung von 2008. Alle Patienten wurden erst nach erfolgter Aufklärung und Einwilligung in die Studie eingeschlossen. Soweit der Beitrag personenbezogene Daten enthält, wurde von den Patienten eine zusätzliche Einwilligung nach erfolgter Aufklärung eingeholt. Author information Authors and Affiliations Corresponding author Additional information Literatur der Masterarbeit ist beim Verfasser erhältlich. Der Beitrag beruht auf der Masterarbeit von Schorpp P (2013) Einfluss osteopathischer Behandlung auf Dysmenorrhö. AV Akademikerverlag. Diese Forschung wurde durchgeführt im Rahmen der Masterthesis in der Master of Science des Osteopathieprogramms, organisiert von der University of Applied Sciences Tirol in Zusammenarbeit mit der International Academy of Osteopathy. Rights and permissions About this article Cite this article Schorpp, P. Osteopathischer Behandlungseffekt auf Dysmenorrhö. Manuelle Medizin 51, 325–332 (2013). https://doi.org/10.1007/s00337-013-1047-3 Published: Issue date: DOI: https://doi.org/10.1007/s00337-013-1047-3

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