Gonzalez-Mena A, Leiros-Rodriguez R, Hernandez-Lucas P Treatment of Women With Primary Dysmenorrhea With Manual Therapy and Electrotherapy Techniques: A Systematic Review and Meta-Analysis. Phys Ther. 2024 May 1;104(5):pzae019. doi: 10.1093/ptj/pzae019. (Systematic review)

OBJECTIVE: The objective of this study was to evaluate the efficacy of electrotherapy and manual therapy for the treatment of women with primary dysmenorrhea.

METHODS: Systematic searches were conducted in Scopus, Web of Science, PubMed, CINAHL, and MEDLINE. The articles must have been published in the last 10 years, had a sample exclusively of women with primary dysmenorrhea, had a randomized controlled trial design, and used interventions that included some form of manual therapy and/or electrotherapy techniques. Two reviewers independently screened articles for eligibility and extracted data. Difference in mean differences and their 95% CIs were calculated as the between-group difference in means divided by the pooled standard deviation. The I2 statistic was used to determine the degree of heterogeneity.

RESULTS: Twelve selected studies evaluated interventions, with 5 evaluating electrotherapy techniques and 7 evaluating manual therapy techniques. All studies analyzed identified improvements in pain intensity and meta-analysis confirmed their strong effect.

CONCLUSIONS: Manual therapy and electrotherapy are effective for the treatment of women with primary dysmenorrhea. Transcutaneous electrical nerve stimulation combined with thermotherapy and effleurage massage stands out for its effects on the intensity and duration of pain with the application of a few sessions and their long-term effects.

IMPACT: Manual therapy techniques and electrotherapy methods reduce the pain intensity of women with primary dysmenorrhea. Quality of life and degree of anxiety improved significantly with manual therapy interventions. Transcutaneous electrical nerve stimulation combined with thermotherapy and effleurage massage are the interventions with which positive effects were achieved with fewer sessions.

Discipline Area Score
Physician 6 / 7
Rehab Clinician (OT/PT) 5 / 7
Comments from MORE raters

Physician rater

These are important findings given some risks with NSAIDs and other treatments. The primary limitation is that these therapies are not widely available or reimbursable across payers and geographic regions.

Physician rater

It is extremely useful to know this information, however, endometriosis as a cause of primary dysmenorrhea is diagnosed more often. Nevertheless, any nonmedical intervention is always an advantage and this information is worthwhile.

Rehab Clinician (OT/PT) rater

This is a seemingly useful clinical techniques to potentially modulated 'myofascial' segmentally related sensitisation and probably quite well recognised for their utility by many practicing in the MSK domain.
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