Premenstrual syndrome (P.M.S.) is a hormone mediated response to fluctuating levels of progesterone and estrogen (sex and reproductive hormones).  Symptoms generally represent the consequences of emotionaI lability (rapid, often exaggerated changes in mood, where strong emotions or feelings occur). For instance, mood swings, anxiety, and depression occur. Furthermore, hormonal effects on neuroendocrine (cells that release hormones into the blood in response to stimulation of the nervous system) function cause headaches, food cravings, fluid retention, breast tenderness or fullness, and back pain.  P.M.S. appears 7 to 10 days prior to menses and improves within hours to days following the onset of menses. After that, dysmenorrhea (menstrual symptoms) may appear.


Dysmenorrhea is the medical term for pain with your period (menstruation) or menstrual cramps. There are two types of dysmenorrhea: primary and secondary. Primary dysmenorrhea is the name for common menstrual cramps that come back over and over again (recurrent). Secondary dysmenorrhea can be due to other diseases.  With secondary dysmenorrhea (due to endometriosis or fibroids), you may want to talk to your doctor (OB/GYN) about a diagnosis and treatment options.


More than half of women who menstruate have some pain for 1 to 2 days each month. Usually, the pain is mild. Others have severe pain with other symptoms, including diarrhea, nausea, vomiting, headache, and dizziness. Above all, it keeps them from doing normal activities for several days a month.


Why Do P.M.S. (Premenstrual Symptoms) and dysmenorrhea occur?

The pituitary gland, a pea-sized gland at the base of the brain, produces a number of hormones. Each of these hormones affects a specific part of the body.  Luteinizing hormone and follicle-stimulating hormone produced by the pituitary, promote ovulation and stimulate the ovaries to produce estrogen and progesterone.

Estrogen and progesterone stimulate the uterus and breasts to prepare for possible fertilization. Estrogen causes the breast ducts to enlarge. Progesterone production causes the milk glands to swell. Both of these events can cause your breasts to feel sore.

Before a period begins, the cells that form the lining of the uterus begin to break down.   As a result, large amounts of inflammatory prostaglandins are released. During menstruation these chemicals constrict the blood vessels in the uterus and make the muscle layer contract, causing painful cramps.  Additionally, prostaglandins can cause symptoms of headache, nausea, vomiting, diarrhea, and urinary frequency.  Heavy contractions can lead to low back pain.  Similarly, lower abdominal pain can radiate into the low back.


Theories to explain why symptoms vary from woman to woman:


-Some women may metabolize progesterone differently with the result of less allopregnenolone. (Allopregnanolone is a neuroactive steroid involved in modulating behavioral functions, stress)


-Serotonin levels decreasing. Serotonin is a key hormone that stabilizes our mood, feelings of well-being, and happiness.


-There is estrogen excess or progesterone deficiency (through stimulation of the renin-angiotensin system and increased levels of aldosterone) leads to fluid retention. The Renin-Angiotensin-Aldosterone System (RAAS) is a hormone system within the body that is essential for the regulation of blood pressure and fluid balance. 


-There are nutritional imbalances in B6 and magnesium, altered blood sugar levels, and prostaglandin imbalance. 


Dr. Natalie adjusts a patient spine and pelvis

Meiri Chiropractic Can Provide Chiropractic Care for Premenstrual Syndrome (PMS) and Menstrual Symptoms


Relieve and manage your PMS and menstrual symptoms naturally with chiropractic care.  After all, pain medications can be harmful and additive. In regards to Chiropractic spinal manipulation studies, most have tested the treatment effect for dysmenorrhea and some studies have indicated manipulation has a positive effect on PMS. The following is recommended along with adjustments:

Exercise may help decrease the frequency or intensity of PMS symptoms.

Stop smoking.

Diet. Recommendations for diet modifications include:

-eat small, regular meals

-follow a low-fat or vegetarian diet; limit red meats, dairy products, foods with a high sugar content, and fried foods

-limit or eliminate caffeine and alcohol

-increase dietary fiber and water (increase to six to eight glasses/day for natural diuresis)

Get enough sleep/relax


Seek the help of an experienced West Palm Beach chiropractor to ensure you get the best Chiropractic Care for Premenstrual Syndrome (PMS) and Menstrual Symptoms. Visit your West Palm Beach chiropractor today to learn about other things you can do to keep your body healthy, or get treatment for acute or chronic pain! 



Walsh MJ, Polus BI. A randomized, placebo-controlled

clinical trial 011 the efficacy of chiropractic therapy on premenstrual

syndrome. J Manipulative Pbysiol Tbe1c 1999;


Oyelowo TA. Diagnosis and management of premenstrual

syndrome in the chiropractic office. Top Clin Cbiro.


Liebl NA, Butler LM. A chiropractic approach to the treatment

of dysmenorrhea. ] lvIrtnipulative Pbysiol Ther.



Meiri Chiropractic




Prospective patients always ask how Meiri Chiropractic is able to help them. Chiropractic care can help with a range of health issues, including chronic/acute pain, and dysfunction. It also keeps you at your peak performance with wellness chiropractic care.  Next, a common question is “how much does chiropractic care cost?”  That can be a complicated question to answer.  The price a patient must pay can vary based on if and what type of insurance a patient has. Also, price may vary based on what specific services are rendered. 


The best way to know for sure if your health insurance will cover a visit is to call us directly to check the details of your policy.  Patients usually do not understand the insurance they carry. While prospective patients may have heard about all the great benefits of chiropractic care, often times they are scared away by worries about how much it will cost. In actuality, their insurance may cover some or all of it.

Many insurance plans will cover the full cost of your chiropractic care. This includes the initial exam, any necessary x-rays, and all necessary treatments. Some insurance plans may cover all these expenses no matter what the problem is while other insurance plans will only cover all of these expenses if the patient has sustained some injury, be it in an automobile accident or another type of accident.

Your plan may require a co-pay, you may have to meet a deductible or it may only cover a percentage of a treatment up to a certain dollar amount. Most plans will front at least some or a majority of your chiropractic care bill, making going to see a chiropractor an affordable option.


Cost of Chiropractic Care:

Does Insurance Cover It?


In our office the majority of patients do use their health insurance to help with the cost of their care. We do, however, see patients that do not have insurance.  Patients without insurance pay for chiropractic care out of their own pocket.  Pricing for the first visit can vary depending on the level of exam performed and x-rays required.  After the first visit, a typical treatment price varies based on how many regions are treated.  Typical patients in our office have the spine and multiple extremities (i.e. arms, legs, hands, feet) treated at each visit.

No matter how you spin it, healthcare can be expensive.  However, visits to the doctors, prescriptions for pain or health management, surgeries, and other healthcare expenses can quickly add up. Medications work temporarily, but are not a long lasting solution.  Medications do not alleviate the root cause of the problem.  This means you’re spending more money on more visits to the doctor or more prescriptions.  When problems worsen, surgeries or even hospitalization can be very costly.  Additionally, time off work can be costly because of illness or chronic pain. 


Cost of Chiropractic Care:

Regular Chiropractic Care Costs Significantly Less Than Conventional Medical Care


The study below looked at the cost of traditional healthcare verses chiropractic care. They  found that undergoing regular chiropractic care was significantly less than the cost of conventional medical expenses:


Low back pain initiated with a doctor of chiropractic (DC) saves 20 to 40 percent on health care costs when compared with care initiated through a medical doctor (MD), according to a study that analyzed data from 85,000 Blue Cross Blue Shield (BCBS) beneficiaries in Tennessee over a two-year span. The study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays. Researchers estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee. They also concluded that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions.

Liliedahl et al (2010), Journal of Manipulative and Physiological Therapeutics


Chiropractic care has been shown to be effective at treating numerous issues, and even doctors that practice conventional medicine recommend it for musculoskeletal conditions.  Moreover, chiropractic is natural and does not utilize drugs or surgery for treatment.

Please contact us with any questions regarding the Cost of Chiropractic Care: Does Insurance Cover It? We would welcome the opportunity to provide you and your family with chiropractic care.


Meiri Chiropractic

5601 Corporate Way, Ste 102

West Palm Beach, FL 33407



From Dr. Natalie Meiri’s Clinical Pearl Stories:

 A Chiropractor Can Help Failed Back Surgery Syndrome 

This was a 87 year old patient who presented to my office with low back pain and pain in both legs. To be HIPAA compliant, I will call him Henry instead of his real name.   Henry had  a laminectomy nearly 10 years ago on his low back. A laminectomy is a surgical procedure that removes a portion of the vertebral bone called the lamina, which is the roof of the spinal canal. Also known as decompression surgery, a laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves. It is a major spine operation with residual scar tissue and may result in Failed Back Surgery Syndrome (FBSS) which was the case with Henry. FBSS patients  have new or persistent pain after spinal surgery for back or leg pain.

Henry had the laminectomy on his L4-L5 vertebra due to a dropped foot.  Although, his dropped foot improved after the surgery, he had pain in his low back and legs which he didn’t have prior to the surgery.  Foot Drop is a term used to describe difficulty lifting the front part of the foot. Common causes are L4-L5 radiculopathy (nerve compression), caused by either a herniated disc, degenerative disc and/or foraminal spinal stenosis, and peroneal peripheral neuropathy in the leg.


Henry’s Medical History


Henry was active in his younger years playing tennis and golf almost every day.  In addition to the laminectomy, Henry had a left total knee replacement a few years ago. He started going to the gym since his knee replacement, but his back and leg pain kept getting worse.  Henry was on numerous drugs for the pain and for his high blood pressure. 


His internist had ordered a doppler ultrasound to rule out a circulation problem in his legs. Henry had tried acupuncture without any success.  Furthermore, the physical therapy treatments at home seemed to help some, but not enough.  Therefore, Henry came to see me. Henry wanted to feel better and go back to the gym.


Henry’s Exam and Imaging

Upon examination, Henry had positive tests for both hips, right knee, both ankles, mid and low back.  X-rays taken in my office showed osteoarthritis (wear and tear arthritis) in his thoracic spine (mid back), lumbar spine (low back), hips, right knee and both ankles.  I would send Henry for further imaging (i.e. magnetic resonance imaging, MRI) or a electromyography (EMG) and nerve conduction study (NCS) if there wasn’t any improvement within 12 visits.


Dr. Meiri adjusts a patient's knee


Henry’s Chiropractic Treatment for Failed Back Surgery Syndrome: Low Force Techniques Were Considered to be Safer

Firstly, Henry’s chiropractic treatment for failed back surgery syndrome consisted of chiropractic manipulation/ adjustments of the lumbopelvic spine and associated regions utilizing low force techniques.  Moreover, the adjustments were delivered around the level of the laminectomy, but not at L4/L5 where the laminectomy was performed. Associated regions that were adjusted were his thoracic spine, both hips, right knee and both ankles which were misaligned (subluxations or intersegmental dysfunctions) due to the conditions he had. Secondly, soft tissue therapy (myofascial release, pressure point and various post isometric relaxation techniques) and modalities (cold/heat therapy and electric muscle stimulation) were administered. Thirdly, he was given therapeutic exercises to continue his treatment at home. 


Henry started feeling better in the first few visits. He wondered why he had waited so long to try chiropractic for this problem?  Many people think they have to live with the pain or dysfunction. Chiropractic adjustments normalize function, restore joint mobility, resolves joint inflammation and reduces the patient’s pain.  Even for post-surgical cases, patients can get fast pain relief and over time improve function.

Do you know someone like Henry who is in need of chiropractic treatment? A Chiropractor Can Help Failed Back Surgery Syndrome.  Contact Dr. Natalie Meiri of Meiri Chiropractic today serving North Palm Beach, Jupiter, West Palm Beach, Palm Beach Gardens and surrounding areas. Get the relief you need and deserve! We also offer chiropractic care for many other ailments. Call 561-253-8984 to learn more or to schedule an appointment.


Meiri Chiropractic

5601 Corporate Way Ste 102

WEst Palm Beach, FL 33407