title: Changes in pain perception after pelvis manipulation in women with primary dysmenorrhea: a randomized controlled trial.
abstract: OBJECTIVE
  This study aims to evaluate the immediate effect of a global pelvic manipulation (GPM) technique, bilaterally applied, on low back pelvic pain in women with primary dysmenorrhea (PD).
  
  
  METHODS
  A prospective, randomized, double-blind, controlled trial.
  
  
  METHODS
  Faculty of Nursing, Physiotherapy and Podiatry. University of Sevilla, Spain.
  
  
  METHODS
  The sample group included 40 women (30 ± 6.10 years) that were divided into an experimental group (EG) (N = 20) who underwent a bilateral GPM technique and a control group (CG) (N = 20) who underwent a sham (placebo) intervention. Evaluations were made of self-reported low back pelvic pain (visual analog scale), pressure pain threshold (PPT) in sacroiliac joints (SIJs), and the endogenous response of the organism to pain following catecholamines and serotonin release in blood levels.
  
  
  RESULTS
  The intragroup comparison showed a significant improvement in the EG in the self-perceived low back pelvic pain (P = 0.003) and in the mechanosensitivity in both SIJs (P = 0.001). In the between-group comparison, there was a decrease in pain perception (P = 0.004; F(1,38) = 9.62; R(2) = 0.20) and an increase in the PPT of both SIJs, in the right side (P = 0.001; F(1,38) = 21.29; R(2) = 0.35) and in the left side (P = 0.001; F(1,38) = 20.63; R(2) = 0.35). There were no intergroup differences for catecholamines plasma levels (adrenaline P = 0.123; noradrenaline P = 0.281; dopamine P = 0.173), but there were for serotonin levels (P = 0.045; F(1,38) = 4.296; R(2) = 0.10).
  
  
  CONCLUSIONS
  The bilateral GPM technique improves in a short term the self-perceived low back pelvic pain, the PPT in both SIJs, and the serotonin levels in women with PD. It shows no significant differences with a sham intervention in catecholamines plasma levels.
authors.affiliation: Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Molins-Cubero
authors.forename: Cleofás
authors.initials: C
authors.lastname: Rodríguez-Blanco
authors.forename: Angel
authors.initials: A
authors.lastname: Oliva-Pascual-Vaca
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Heredia-Rizo
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Boscá-Gandía
authors.forename: François
authors.initials: F
authors.lastname: Ricard
mesh_terms: D000328:Adult; D002395:Catecholamines / Q000097:blood; D004412:Dysmenorrhea / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000628:therapy*; D026201:Musculoskeletal Manipulations; D010147:Pain Measurement; D058748:Pain Perception; D017288:Pain Threshold; D010384:Pelvic Bones; D011312:Pressure / Q000009:adverse effects; D011446:Prospective Studies; D012446:Sacroiliac Joint; D012701:Serotonin / Q000097:blood; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D002395:Catecholamines; D012701:Serotonin
keywords: Catecholamines; Manipulation Spinal; Pain Threshold; Pelvic Pain; Primary Dysmenorrhea; Serotonin