How Can Physiotherapy Help With Painful Periods?
Painful periods, also known as dysmenorrhea, are a common challenge for many menstruating individuals. Dysmenorrhea can severely impact daily functioning and quality of life, with symptoms ranging from lower abdominal cramping to back pain, pelvic discomfort, and even psychological effects like anxiety and depression. This article explores how physiotherapy can provide relief, particularly for conditions like endometriosis—a common yet often misunderstood cause of chronic pelvic pain.
Understanding Dysmenorrhea and Endometriosis
Dysmenorrhea—a Greek term meaning “painful monthly bleeding”— depending on the studies, can affect as many as 90% of menstruating individuals. Severe pain can be classified into two types:
- Primary dysmenorrhea: Recurrent menstrual pain without underlying conditions.
- Secondary dysmenorrhea: Pain linked to conditions such as endometriosis or adenomyosis
People may perceive this pain to be in the abdomino-pelvic, pelvic floor, perineal or low back region, or a combination of these.
How Physiotherapy Can Help
Physiotherapy offers a range of non-invasive interventions that target both the physical and psychological aspects of painful periods. Here are the primary techniques:
1. Abdominal Stretching
Abdominal stretching is a very simple, efficient, and risk-free workout. Some of the advantages of stretching exercises for dysmenorrhea include increased adaptability and strength of the spine and pelvic floor muscles, the inspiratory muscle becoming more flexible and stronger, oxygen supply and other fluids being transmitted properly to the uterus, decreased joint and back pain, stimulation of desire to eat and bowel action, anemia reduction and free passage during the menstrual cycle, and hormonal balance.
Examples of effective stretches include:
- Backward trunk bending
- Pelvic bridging
- Trunk side flexion (bilateral)
By dedicating 10–15 minutes daily to stretching, individuals may experience improved pelvic function and reduced menstrual discomfort.
2. Connective Tissue Massage (CTM)
Connective tissue massage (CTM) is a type of therapy used by physiotherapists (sometimes, we teach patients simple self-massage techniques to perform at home as an extension of the treatment). CTM focuses on stimulating the skin and underlying connective tissues to influence internal organs through reflex pathways. Physiotherapists apply firm pressure to ligaments and subcutaneous tissues to activate mechanical receptors in the connective tissue. This technique helps treat various issues related to muscles, joints, and internal organs, especially for pain relief and pelvic organ dysfunctions. Common areas treated include the sacrum, lower back, neck, areas below the ribs, and the mid-back. CTM is effective in improving mobility and reducing pain.
3. Visceral Manual Techniques
This therapy focuses on the interplay between organs, muscles, and connective tissues. Physiotherapists assess the mobility of abdominal and pelvic organs to identify restrictions caused by scar tissue, adhesions, or tension.
By restoring movement and balance between structures, this approach helps reduce pain and improve functionality.
4. Uterine Palpation and Relaxation Techniques
Physiotherapists use palpation to assess the mobility, shape, and position of the uterus. Resistance or pain during palpation may indicate adhesions or restricted movement. Uterine relaxation techniques can improve vascular drainage and reduce tension, enhancing overall comfort during menstruation.
5. Trigger Point Therapy
Myofascial trigger points (MTrPs) in the pelvic region can contribute to chronic pain. Transvaginal techniques are sometimes used to deactivate these hypersensitive nodules, offering targeted relief for conditions like endometriosis.
6. TENS Therapy
Transcutaneous Electrical Nerve Stimulation (TENS) is a non-invasive method proven effective for managing menstrual pain. By placing electrodes on the lower abdomen or back, TENS stimulates nerves to reduce pain perception. Sessions typically last 20–30 minutes and can be used as needed.
7. Exercise Prescription
Regular physical activity—such as brisk walking, swimming, or Pilates—can help alleviate menstrual pain. Aerobic exercises increase endorphin levels, improving mood and reducing discomfort.
Physiotherapists recommend:
- 30 minutes of aerobic exercise, 3 times per week
- Avoiding excessive abdominal strengthening during periods
- Focusing on gentle, restorative movements and stretching
Finding Relief and Support
Physiotherapy plays a vital role in improving the lives of women with endometriosis-related pain such as dysmenorrhea. Techniques like abdominal stretching, connective tissue massage, and TENS therapy offer non-invasive options for managing pain.
If you’re experiencing painful periods or suspect you may have endometriosis, consult a healthcare provider or physiotherapist. With the right interventions, you can take steps toward relief and reclaim your quality of life.
References:
Transcutaneous Electrical Nerve Stimulation (TENS) for Primary Dysmenorrhea: An Overview - PMC
The Effect of aerobic exercise on primary dysmenorrhea: A clinical trial study - PMC
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