Table 1. Types of osteopathic manipulation techniques used and their associated results.

HVLA: high-velocity low-amplitude; EMG: electromyography; OMT: osteopathic manipulative treatment; MFR: myofascial release; CS: counterstrain; ST: soft tissue; ME: muscle energy; VAS: Visual Analog Scale; PPT: pressure pain threshold; BLT: balanced ligamentous tension; WaLIDD: Working ability, Location, Intensity, Days of Pain, Dysmenorrhea; API: Average Pain Intensity; DDP: Days of Dysmenorrheal Pain

Study	Osteopathic techniques	Results
Boesler et al. [15]	HVLA	EMG in lumbar extension showed significant decrease in activity with OMT. Lab testing found no difference in total creatinine, total lactate dehydrogenase, or myoglobin/creatinine ratio.
Emo and Blumer [16]	MFR	Decrease in the duration of pain during a menstrual cycle when compared to the control.
Hitchcock [8]	Sacral inhibition, structural pressure, lymphatic pump	Decrease in menstrual disability, menstrual pain, and associated back pain.
Matsushita et al. [9]	MFR, CS, ST, ME, suboccipital release, abdominal plexus release, joint articulation	Adult onset of secondary dysmenorrhea improvement from stages 2-3 to stages 0-1 over six months after undergoing six OMT sessions.
Molins-Cubero et al. [17]	HVLA	Decrease in VAS and increase in PPT on the left sacroiliac joint. Serotonin, adrenaline, and dopamine levels increased and noradrenaline decreased after intervention.
Origo et al. [18]	Unwinding techniques, lumbosacral decompression, pelvic floor release, HVLA, BLT	Pain reduction of 50% during the menstruation week, WaLIDD improvement of 70%, and complete recovery from dyspareunia.
Ruffini et al. [10]	HVLA, MFR, ST, ME, rib raising, CS, lymphatic pump	Decrease in pain grade and analgesic use.
Schwerla et al. [19]	Appropriate techniques based on the dysfunction identified	API decreased from 4.6 to 1.9 in the intervention group vs 4.3 to 4.2 in the control group (p<0.005). DDP also decreased from 2.2 to 0.2 days in the intervention group vs 2.3 to 1.9 in the control group (p=0.002). A positive impact on quality of life was observed only in the intervention group.
Vlachos and Lagattuta [20]	HVLA, ME, MFR, BLT	Reduction in menstrual pain and duration.
Yosri et al. [21]	Visceral manipulation	Statistically significant improvement (p=0.024) in the severity of menstruation-related problems.