Instant Effect Of Radial Extracorporeal Shock Wave Therapy On Pain And Mood In Primary Dysmenorrhea

Objective: Primary dysmenorrhea(PDM)is a common chronic visceral pain in young women with no pelvic organic changes,which main manifestation is periodic,spasmodic pain in the lower abdomen during menstruation.It is often accompanied by headache,nausea,vomiting,diarrhea and other symptoms.Radial extracorporeal shock wave therapy is a treatment consisting of radially expanding shock waves,which is often used for the treatment of musculoskeletal pain.However,there is no study has explored its immediate effect on pain and mood in PDM patients after rESWT intervention.This study aimed to provide neuroimaging evidence for the clinical application of rESWT in PDM from the perspective of resting brain functional activity through the immediate effects of rESWT on pain and mood in PDM patients.Methods: 39 subjects were recruited and randomly assigned to the shockwave group(20 patients)and the sham shockwave group(19 patients).During the nonmenstrual period,the evaluator assessed the subjects' anxiety and mood,and the radiologist collected resting brain imaging data.Intervention was conducted within 48 hours after menstruating.Data on pain intensity,dysmenorrhea symptoms,mood and resting brain functional activity were collected before and after the intervention,respectively.Results:1.For pain intensity,pain rating index(PRI),visual analog scale(VAS)and existing pain intensity(PPI)were significantly decreased before and after intervention in both groups(P < 0.001).There were no significant difference in PRI,VAS and PPI between two groups.2.For dysmenorrhea symptoms,abdominal pain,nausea,vomiting,backaches,weakness,dizziness,diarrhoea,facial blemishes,depression,irritability and nervousness were significantly decreased in the shockwave group after intervention(P <0.05).In the sham shockwave group,abdominal pain,nausea,headaches,backaches,leg aches,weakness,dizziness,diarrhoea,facial blemishes,sleeplessness,depression,irritability and nervousness were significantly decreased after intervention(P <0.05).There were no significant difference in each item between two groups.3.For anxiety,the anxiety score was reduced both in the shockwave group and the sham shockwave group after intervention(P < 0.001).There were no significant difference between the two groups over three time periods.4.For depression,there was no significant difference in depression scores at each stage.There were no significant difference in the depression score in the two groups among three time periods.5.For the fraction amplitude of low frequency fluctuation,in the shockwave group,left middle temporal gyrus decreased significantly after intervention compared with that of the non-menstrual phase(P < 0.001).There were no significant difference in the fraction amplitude of low frequency fluctuation of left middle temporal gyrus between the two groups over three time points.Conclusion: Compared with a sham shockwave treatment,a single shockwave treatment did not significantly improve pain intensity,pain symptoms,anxiety,depression,and the value of fraction amplitude of low frequency fluctuation in patients with primary dysmenorrhea immediately.