Dysmenorrhea, or painful menstruation, is very common and occurring at least occasionally in almost all menstruating women. Pain occurs in the abdominopelvic or low back region. The sensations are felt as cramps, and usually occur in successive waves or as a persistent cramp. Massage can be performed. If the client’s abdomen is tender, massage over the area is contraindicated because the pressure of massage can induce more pain. If pain and muscle tension in the low back are present, muscles such as quadratus lumborum, latissimus dorsi, the paraspinals, and possibly the gluteals can be addressed specifically with such techniques as deep gliding, deep friction, kneading, and stretches. The client may need to be propped with a pillow under her abdomen while she is prone. If this is uncomfortable, the side-lying position is permissible. The therapist should also recognize that if the client has severe cramps prior to or during the massage, the client may not desire further treatment.

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