Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20230042-en
Brazilian Journal of Pain
Original Article

How does my pain look like? Characterizing dysmenorrhea-related pain using the body map

Como se parece a minha dor? Caracterizando a dor relacionada à dismenorreia utilizando o mapa corporal da dor

Jéssica Cordeiro Rodrigues; Mariana Arias Avila; Felipe José Jandre dos Reis; Adriana Menezes Degani; Guilherme Tavares de-Arruda; Patricia Driusso

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Abstract

BACKGROUND AND OBJECTIVES: Primary dysmenorrhea (PD) is a common gynaecological disorder characterized by pain in the abdominal region without pelvic disease. Evidence suggests that PD-related pain may not be restricted to the pelvis region, hence body mapping could be helpful in assessing the subjective location, intensity, and distribution of pain areas in women with PD. The objective of this study was to characterize dysmenorrhea-related pain location and intensity using body map. 
METHODS: We conducted a web-based cross-sectional study for adult women to self-report menstrual pain during three menstrual cycles. Each participant was instructed through a messaging application to paint the body map after printing it and rank their pain according to the 11-point Numerical Rating Scale. 
RESULTS: Seventy-three women (24.1 ± 3.0 years) participated in the study. A considerable proportion of participants reported pain in the lower abdomen (90.4%) and other body areas, such as the lower back (82.1%), head (54.6%), breasts (32.9%), upper abdomen (31.5%), and legs (28.8%). 
CONCLUSION: Our findings revealed that women with PD also present pain outside the uterine referral area during their period. In this way, body maps can help healthcare professionals to record specific regions of pain and track changes or patterns in the location or intensity pain during menses, helping to determine treatment strategies appropriate to the individual needs of each woman with PD. Therefore, we strongly recommend the clinical use of the self-report body map to evaluate menstrual pain and help health providers to improve PD symptoms in this population.

Keywords

Dysmenorrhea, Pain, Women’s health

Resumo

JUSTIFICATIVA E OBJETIVOS: A dismenorreia primária (DP) é um distúrbio ginecológico comum caracterizado por dor na região abdominal sem doença pélvica. Evidências sugerem que a dor relacionada à DP pode não estar restrita à região da pelve, portanto, o mapeamento corporal pode ser útil para avaliar a localização subjetiva, a intensidade e a distribuição das áreas de dor em mulheres com DP. O objetivo deste estudo foi caracterizar a localização e a intensidade da dor relacionada à dismenorreia por meio do mapa corporal. 
MÉTODOS: Conduziu-se um estudo transversal baseado na web para mulheres adultas para autorrelato de dor menstrual durante três ciclos menstruais. Cada participante foi instruído por meio de um aplicativo de mensagens a pintar o mapa corporal após imprimi-lo e classificar sua dor de acordo com a Escala de Avaliação Numérica de 11 pontos. 
RESULTADOS: Setenta e três mulheres (24,1±3,0 anos) participaram do estudo. Uma proporção considerável de participantes relatou dor na parte inferior do abdômen (90,4%) e em outras áreas do corpo, como a parte inferior das costas (82,1%), cabeça (54,6%), mamas (32,9%), parte superior do abdômen (31,5%) e pernas (28,8%). 
CONCLUSÃO: Os presentes achados revelaram que mulheres com DP também apresentam dor fora da área de referência uterina durante o período menstrual. Dessa forma, os mapas corporais podem ajudar os profissionais de saúde a registrar regiões específicas de dor e rastrear mudanças ou padrões na localização ou intensidade da dor durante a menstruação, ajudando a determinar estratégias de tratamento adequadas às necessidades individuais de cada mulher com DP. Portanto, recomenda-se fortemente o uso clínico do mapa corporal de autorrelato para avaliar a dor menstrual e ajudar os profissionais de saúde a melhorar os sintomas de DP nessa população.

Palavras-chave

Dismenorreia, Dor, Saúde da mulher

References

1 Iacovides S, Avidon I, Baker FC. What we know about primary dysmenorrhea today: a critical review. Hum Reprod Update. 2015;21(6):762-78.

2 Proctor M, Farquhar C. Diagnosis and management of dysmenorrhoea. BMJ. 2006;332(7550):1134-8.

3 Chen CX, Kwekkeboom KL, Ward SE. Self-report pain and symptom measures for primary dysmenorrhoea: a critical review. Eur J Pain. 2015;19(3):377-91.

4 Chen CX, Draucker CB, Carpenter JS. What women say about their dysmenorrhea: a qualitative thematic analysis. BMC Womens Health. 2018;18(1):47.

5 de Arruda GT, Driusso P, Rodrigues JC, de Godoy AG, Degani A, Danna-Dos-Santos A, Avila MA. Are menstrual symptoms associated with central sensitization inventory? A cross-sectional study. Eur J Pain. 2022;26(8):1759-67.

6 Yunus MB. Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. Semin Arthritis Rheum. 2008;37(6):339-52.

7 Affaitati G, Costantini R, Tana C, Cipollone F, Giamberardino MA. Co-occurrence of pain syndromes. J Neural Transm. 2020;127(4):625-46.

8 Shaballout N, Neubert TA, Boudreau S, Beissner F. From paper to digital applications of the pain drawing: systematic review of methodological milestones. JMIR mHealth uHealth. 2019;7(9):e14569.

9 Margolis RB, Tait RC, Krause SJ. A rating system for use with patient pain drawings. Pain. 1986;24(1):57-65.

10 Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45-56.

11 Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, Fainsinger R, Aass N, Kaasa S; European Palliative Care Research Collaborative (EPCRC). Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011;41(6):1073-93

12 de Arruda GT, Driusso P, Rodrigues JC, de Godoy AG, Avila MA. Numerical rating scale for dysmenorrhea-related pain: a clinimetric study. Gynecol Endocrinol. 2022;38(8):661-5.

13 Keller S, Bann CM, Dodd SL, Schein J, Mendoza TR, Cleeland CS. Validity of the brief pain inventory for use in documenting the outcomes of patients with noncancer pain. Clin J Pain. 2004;20(5):309-18.

14 Brummett CM, Bakshi RR, Goesling J, Leung D, Moser SE, Zollars JW, Williams DA, Clauw DJ, Hassett AL. Preliminary validation of the Michigan Body Map. Pain. 2016;157(6):1205-12.

15 Rodrigues JC, Avila MA, Dos Reis FJJ, Carlessi RM, Godoy AG, Arruda GT, Driusso P. ‘Painting my pain’: the use of pain drawings to assess multisite pain in women with primary dysmenorrhea. BMC Womens Health. 2022;22(1):370.

16 Malta M, Cardoso LO, Bastos FI, Magnanini MMF, Silva CMFP da. STROBE initiative: guidelines on reporting observational studies. Rev Saude Publica. 2010;44(3):559-65.

17 Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF). Arthritis Care Res (Hoboken). 2011;63(S11):S240-S252.

18 Smith DR, Mihashi M, Adachi Y, Shouyama Y, Mouri F, Ishibashi N, Ishitake T. Menstrual disorders and their influence on low back pain among Japanese nurses. Ind Health. 2009;47(3):301-12

19 Carroquino-Garcia P, Jiménez-Rejano JJ, Medrano-Sanchez E, de la Casa-Almeida M, Diaz-Mohedo E, Suarez-Serrano C. Therapeutic exercise in the treatment of primary dysmenorrhea: a systematic review and meta-analysis. Phys Ther. 2019;99(10):1371-80.

20 Ferries-Rowe E, Corey E, Archer JS. Primary dysmenorrhea. Obstet Gynecol. 2020;136(5):1047-58.

21 Iacovides S, Baker FC, Avidon I, Bentley A. Women with dysmenorrhea are hypersensitive to experimental deep muscle pain across the menstrual cycle. J Pain. 2013;14(10):1066-76.

22 Granella F, Sances G, Allais G, Nappi RE, Tirelli A, Benedetto C, Brundu B, Facchinetti F, Nappi G. Characteristics of menstrual and nonmenstrual attacks in women with menstrually related migraine referred to headache centres. Cephalalgia. 2004;24(9):707-16.

23 Nattero G, Allais G, De Lorenzo C, Torre E, Ancona M, Benedetto C, Massobrio M. Menstrual migraine: new biochemical and psychological aspects. Headache. 1988;28(2):103-7.

24 Nattero G, Allais G, De Lorenzo C, Benedetto C, Zonca M, Melzi E, Massobrio M. Relevance of prostaglandins in true menstrual migraine. Headache. 1989;29(4):233-8.

25 Smith RL, Pruthi S, Fitzpatrick LA. Evaluation and management of breast pain. Mayo Clin Proc. 2004;79(3):353-72.

26 Walsh P V, McDicken IW, Bulbrook RD, Moore JW, Taylor WH, George WD. Serum oestradiol-17β and prolactin concentrations during the luteal phase in women with benign breast disease. Eur J Cancer Clin Oncol. 1984;20(11):1345-51.

27 Sitruk-ware LR, Sterkers N, Mowszowicz I, Mauvais-Jarvis P. Inadequate corpus luteal function in women with benign breast diseases. J Clin Endocrinol Metab. 1977;44(4):771-4.

28 Bair MJ, Robinson RL, Eckert GJ, Stang PE, Croghan TW, Kroenke K. Impact of Pain on Depression Treatment Response in Primary Care. Psychosom Med. 2004;66(1):17-22.

29 Seidman L, Temme CR, Zeltzer LK, Rapkin AJ, Naliboff BD, Payne LA. Ecological momentary assessment of non-menstrual pelvic pain: potential pathways of central sensitization in adolescents and young adults with and without primary dysmenorrhea. J Pain Res. 2020;13:3447-56.

30 Payne LA, Seidman LC, Sim MS, Rapkin AJ, Naliboff BD, Zeltzer LK. Experimental evaluation of central pain processes in young women with primary dysmenorrhea. Pain. 2019;160(6):1421-30.

31 Vincent K, Warnaby C, Stagg CJ, Moore J, Kennedy S, Tracey I. Dysmenorrhoea is associated with central changes in otherwise healthy women. Pain. 2011;152(9):1966-75.

32 Southerst D, Côté P, Stupar M, Stern P, Mior S. The reliability of body pain diagrams in the quantitative measurement of pain distribution and location in patients with musculoskeletal pain: a systematic review. J Manipulative Physiol Ther. 2013;36(7):450-9.

33 Foxen-Craft E, Scott EL, Kullgren KA, Philliben R, Hyman C, Dorta M, Murphy A, Voepel-Lewis T. Pain location and widespread pain in youth with orthopaedic conditions: exploration of the reliability and validity of a body map. Eur J Pain. 2019;23(1):57-65.

34 Caseiro M, Woznowski-Vu A, De Oliveira AS, Reis FJJ, Wideman TH. From paper to digitalized body map: a reliability study of the pain area. Pain Pract. 2019;19(6):602-8.
 


Submitted date:
04/13/2023

Accepted date:
06/06/2023

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