Effects of Sacroiliac Joint Manipulation on Autonomic Nervous System and Lower Abdominal Pain in Women with Primary Dysmenorrhoea: A Randomized Controlled Trial

Background and Objectives: Autonomic nervous system (ANS) disorders are responsible for primary dysmenorrhea and are closely linked to the spine. This study aims to evaluate the effects of sacroiliac joint manipulation on the ANS and lower abdominal pain in women with primary dysmenorrhea and proposes an alternative treatment method. Materials and Methods: A total of 40 participants were randomly assigned; however, 35 participants remained in the final analysis after 5 dropped out; they were assigned to either the sacroiliac joint manipulation group (n = 18) or the superficial heat therapy group (n = 17). Assessments included heart rate variability (HRV), visual analogue scale (VAS) scores for lower abdominal pain, the pressure pain threshold (PPT) of the sacroiliac joint, and the Moos Menstrual Distress Questionnaire (MMDQ) at baseline and after 4 weeks. Only the VAS and MMDQ scores were reassessed after 8 weeks to evaluate the sustained effects of the treatment. Results: Changes in HRV showed improvements in ANS balance only in the sacroiliac joint manipulation group (p < 0.05). It was found to be more effective than superficial heat therapy (p < 0.05). A significant decrease in lower abdominal pain following the intervention was observed in both groups (p < 0.05), along with the sustained effects of the treatment (p < 0.05). The MMDQ scores decreased after sacroiliac joint manipulation (p < 0.05), with greater improvements compared to the superficial heat therapy (p < 0.05). Conclusions: Sacroiliac joint manipulation positively affects ANS balance and is effective in alleviating lower abdominal pain and menstruation-related symptoms, with sustained effects observed over time. Therefore, sacroiliac joint manipulation can be an effective alternative treatment for women with primary dysmenorrhea.