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Exercise ‘No Aid’ for Period Pain

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Exercise does not help to alleviate period pain, despite it being commonly recommended for women with monthly symptoms, say researchers.
A study of more than 650 university students reported in BJOG found 28% had moderate to severe period pain.

But Birmingham University researchers said they found no link with the amount of exercise the participants did.

GPs said women should be encouraged to do exercise regardless but drugs are available for those with period pain.

The study authors said beliefs about exercise being an effective treatment for bad period pain had persisted for years.

They carried out a questionnaire among 18 to 25-year-olds to find out what age they started their period, how often they had periods, what contraception they used, and whether they had children or had any conditions such as endometriosis or fibroids.

The students were also asked what type of exercise they did and how often as well as other general lifestyle questions.

Responses showed that 72% had no or very little period pain but 28% had moderate to severe pain with their monthly cycle.

After taking into account mood, ethnicity, weight, smoking, and use of the contraceptive pill, they found no link with how much exercise a woman did and whether she suffered from period pain, or how bad her pain was.

‘Anecdotal beliefs’:-

Researcher, Dr Amanda Daley concluded that more research was needed before women are told that exercise will reduce of alleviate period pain.

“Anecdotal beliefs that exercise is an effective treatment have prevailed for many years and while it might seem intuitively appealing to promote exercise as a treatment for menstrual disorders, the findings from this study, along with many others, would not support such a view.

“Of course there are many other important health reasons for encouraging women to be physically active and exercise performed in moderation is unlikely to be harmful.”

Royal College of GPs chairman Professor Steve Field said women with period pain should do what works for them and exercise might make them feel better in general.

“It is a common problem and people usually self-medicate.

“Some exercise is good for you of course but the main treatment for period pain is the contraceptive pill.

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Source: BBC News. Dec.12’09

Simple Therapy for Back Pain

Paracetamol and keeping active are the best cures for back pain, according to Australian researchers who warn that other treatments do not work.

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A Lancet study of 240 back pain sufferers found anti-inflammatory drugs and spinal manipulation did not make any difference to recovery time.

Yet currently, both treatments are recommended in several guidelines.

Experts said patients needed to be reassured that avoiding bed rest and taking paracetamol would work.

Researchers at the University of Sydney assigned patients to receive either an anti-inflammatory drug called diclofenac, a dummy drug, spinal manipulation or fake manipulation therapy.

They had already received simple treatment advice from their GP to keep active, avoid bed rest and take paracetamol for the pain.

The study found no difference in recovery times after 12 weeks in patients who also received diclofenac or spinal manipulation.

Almost all the patients had recovered by the end of the study no matter what treatment they had received.

Adverse effects

Study leader Mark Hancock said there was no clinical benefit from the additional treatments.

And both non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac or ibuprofen, and spinal manipulation are associated with adverse effects, he added.

“GPs can manage patients confidently without exposing them to increased risks and costs associated with NSAIDs or spinal manipulative therapy,” he said.

Dr Bart Koes from the Department of General Practice at Erasmus University in the Netherlands, who wrote an accompanying article in The Lancet, said the results were probably applicable to other non-steroidal anti-inflammatory drugs, such as ibuprofen.

He told the BBC: “It is very likely that for many patients with acute low back pain currently treated with NSAIDs and/or spinal manipulation this would not have been needed if adequate first-line treatment with paracetamol and advice and reassurance was given.”

Dr Stuart Derbyshire, senior lecturer in the School of Psychology and expert in pain at the University of Birmingham, also agreed with the findings.

“For most people, providing simple care and advice should guide the patient through their acute phase of pain and allow them to return to normal life when that acute phase is over.”

Back pain is the largest single cause of sickness absence from work.

But Tony Metcalfe, president of the British Chiropractic Association warned the therapy in the study could not be compared with the treatment provided by chiropracters in the UK.

“Spinal manipulation is just part of a package of care offered by BCA chiropractors which also includes lifestyle and posture advice, rehabilitation and specific exercises.”

He added that spinal manipulation therapy is a safe treatment and none of the study participants reported serious adverse reactions.

Nia Taylor, chief executive of BackCare said the key message for people was to keep moving.

“We know that many GPs feel ill-equipped to help patients with low back pain and sometimes people are not given the right advice and reassurance when they first see a GP.”

She added: “In the UK a standard appointment of 10 minutes may not be long enough to give adequate advice and reassurance and convince the patient that a regime of paracetamol and keeping active is enough to ensure recovery.”

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Sources: BBC NEWS:Nov 9th. ’07