Background: Primary dysmenorrhea is defined as cramping pain in the lower abdomen and suprapubic region, occurring just before or during menstruation, in the absence of pelvic disease. The main cause of primary dysmenorrhea is an overproduction of endometrial prostaglandins which causes myometrial hypercontractility of the uterus, resulting in ischemia and hypoxia of the uterine muscle and, ultimately, the onset of pain. The first-line treatment for this disease is pharmacological, with the aim of inhibiting the synthesis of prostaglandins, mainly through the administration of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or oral contraceptives. However, the ineffectiveness of these treatments in some cases and the unleashing of adverse reactions in the long term have led to the need to investigate the efficacy of non-pharmacological alternative conservative treatments and non-invasive therapies, such as physiotherapeutic interventions. Purpose of the thesis: The goal of this paper is to research in the literature which is currently the most effective physiotherapy treatment in reducing pain and improving the quality of life of women suffering from primary dysmenorrhea. Specifically, then, which type of therapeutic exercise is able to reduce the duration and intensity of pain more. Materials and methods: A literature search was done in the main biomedical databases: PubMed, PEDro and Cochrane Library. The search in PubMed was carried out with a specific search string, while the keywords “primary dysmenorrhea”, “manipulation”, “exercise” were used on PEDro and Cochrane Library. A total of 9 articles were extrapolated and analyzed, including 1 Cochrane Systematic Review, 5 SRs and 3 RCTs. A treatment proposal was then elaborated, based on the evidence found in the literature, and an educational brochure. Results: According to recent evidence, the benefits of therapeutic exercise are more shared and investigated than those deriving from manual therapy. Therapeutic exercise, regardless of type and intensity, appears to be a useful therapeutic option for pain relief in young women with primary dysmenorrhea, with a moderate recommendation for pain intensity and low for pain duration and quality of life.
Background: La dismenorrea primaria è definita come un dolore crampiforme nel basso addome e in regione sovrapubica, che insorge appena prima o durante le mestruazioni, in assenza di una patologia pelvica. La principale causa è una sovraproduzione di prostaglandine dell’endometrio che determina una ipercontrattilità miometriale dell’utero, con conseguente ischemia e ipossia del muscolo uterino e, in definitiva, l’insorgenza del dolore. Il trattamento di prima linea è di tipo farmacologico, con lo scopo di inibire la sintesi delle prostaglandine, principalmente tramite somministrazione di Farmaci Antinfiammatori Non Steroidei (FANS) o di contraccettivi orali. Tuttavia l’inefficacia di questi trattamenti in alcuni casi e lo scatenarsi di reazioni avverse nel lungo periodo hanno portato alla necessità di indagare l’efficacia di trattamenti conservativi alternativi non farmacologici e terapie non invasive, quali possono essere gli interventi fisioterapici. Scopo della tesi: L’obiettivo di questo elaborato è di ricercare in letteratura quale risulta essere attualmente il trattamento fisioterapico più efficace nel ridurre il dolore e migliorare la qualità di vita delle donne che soffrono di dismenorrea primaria. Nello specifico poi, quale tipologia di esercizio terapeutico è in grado di ridurre maggiormente la durata e l’intensità del dolore. Materiali e metodi: È stata eseguita una ricerca bibliografica nei principali database biomedici: PubMed, PEDro e Cochrane Library. La ricerca in PubMed è stata effettuata con una stringa di ricerca specifica, mentre su PEDro e Cochrane Library sono state utilizzate le parole chiave “primary dysmenorrhea”, “manipulation”, “exercise”. Sono stati estrapolati e analizzati un totale di 9 articoli, di cui 1 Cochrane Systematic Review, 5 SR e 3 RCT. È stata poi elaborata una proposta di trattamento, basata sulle evidenze reperite dalla letteratura, ed un opuscolo educativo. Risultati: Secondo le recenti evidenze, i benefici derivanti dall'esercizio terapeutico sono maggiormente condivisi ed indagati rispetto a quelli derivanti dalla terapia manuale. L'esercizio terapeutico, indipendentemente dalla tipologia ed intensità, sembra essere un'utile opzione terapeutica per la riduzione del dolore nelle giovani donne con dismenorrea primaria, con una raccomandazione moderata per l’intensità del dolore e bassa per la durata del dolore e la qualità di vita.
Efficacia dell'intervento fisioterapico per la riduzione del dolore nelle donne affette da dismenorrea primaria: revisione della letteratura e proposta di trattamento
VALENTE, ERICA
2021/2022
Abstract
Background: Primary dysmenorrhea is defined as cramping pain in the lower abdomen and suprapubic region, occurring just before or during menstruation, in the absence of pelvic disease. The main cause of primary dysmenorrhea is an overproduction of endometrial prostaglandins which causes myometrial hypercontractility of the uterus, resulting in ischemia and hypoxia of the uterine muscle and, ultimately, the onset of pain. The first-line treatment for this disease is pharmacological, with the aim of inhibiting the synthesis of prostaglandins, mainly through the administration of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or oral contraceptives. However, the ineffectiveness of these treatments in some cases and the unleashing of adverse reactions in the long term have led to the need to investigate the efficacy of non-pharmacological alternative conservative treatments and non-invasive therapies, such as physiotherapeutic interventions. Purpose of the thesis: The goal of this paper is to research in the literature which is currently the most effective physiotherapy treatment in reducing pain and improving the quality of life of women suffering from primary dysmenorrhea. Specifically, then, which type of therapeutic exercise is able to reduce the duration and intensity of pain more. Materials and methods: A literature search was done in the main biomedical databases: PubMed, PEDro and Cochrane Library. The search in PubMed was carried out with a specific search string, while the keywords “primary dysmenorrhea”, “manipulation”, “exercise” were used on PEDro and Cochrane Library. A total of 9 articles were extrapolated and analyzed, including 1 Cochrane Systematic Review, 5 SRs and 3 RCTs. A treatment proposal was then elaborated, based on the evidence found in the literature, and an educational brochure. Results: According to recent evidence, the benefits of therapeutic exercise are more shared and investigated than those deriving from manual therapy. Therapeutic exercise, regardless of type and intensity, appears to be a useful therapeutic option for pain relief in young women with primary dysmenorrhea, with a moderate recommendation for pain intensity and low for pain duration and quality of life.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/39959