Effectiveness of transcutaneous electrical nerve stimulation vs soft tissue manipulation in alleviating pain associated with primary dysmenorrhea

Abstract

Background: Primary dysmenorrhea is common in adolescents and young women, presenting as pelvic cramping pain without underlying pathology. It results mainly from excessive prostaglandin release causing uterine hyper contractility and ischemia. Non-pharmacological treatments like TENS and STM have been studied for pain relief, though their effectiveness remains variably reported.Purpose: This study aimed to compare the effectiveness of TENS and STM in reducing menstrual pain intensity among women with primary dysmenorrhea. Subjects and Methods: A total of 40 participants diagnosed with primary dysmenorrhea were randomly allocated into two equal groups: TENS group (20) and STM group (20). Baseline pain intensity was assessed using the Visual Analog Scale (VAS), and functional limitations were assessed using the WaLidd score before intervention. Intervention: The TENS group received high-frequency, low-intensity stimulation for 20 minutes over the lower abdomen during the first day of menstruation. The STM group received standardized abdominal and lumbosacral soft tissue manipulation for the same duration. Post-treatment VAS scores were recorded immediately after the intervention. Results: Both groups demonstrated a reduction in mean VAS scores and improved functional ability post-treatment. However, the TENS group showed a significantly greater reduction in pain compared to the STM group (Mann–Whitney U = 6.000, p < 0.001).Conclusion: TENS proved more effective than STM in alleviating pain associated with primary dysmenorrhea. Given its non-invasive, easy-to-administer nature, TENS may be recommended as a first-line physiotherapeutic intervention for menstrual pain management. Further studies with larger samples and long-term follow-up are warranted.