Fibromyalgia (FM) is a chronic disorder involving widespread pain and sensitivity in the entire musculoskeletal system. To be diagnosed with FM, a patient will typically possess a minimum of 11 out of 18 specific tender points on the body. In addition to pain, patients will also report long-term fatigue, and/or disturbed sleep and mood. Other disorders commonly associated with FM may include: irritable bowel syndrome, TMJ pain and dysfunction, psychological conditions and some autoimmune diseases.
Fibromyalgia is a widespread condition. Some investigators estimate as many as 2% of the general population in the United States suffers from FM, with women affected 10 times more than men.1 With the combination of symptoms faced by the FM patient, finding the solution to this problem is a tough task.
Medical science is yet to discover the cause for this condition. Because there are so many different symptoms associated with fibromyalgia, there are just as many theories for what causes it. Since those with FM often experience an altered mood – such as depression – many experts focus on the psychological aspect of the disease. Others feel that FM is more a physiological entity, and has its origins in physical trauma or chronic postural alterations. Some suggest that FM is a central nervous system disorder, with imbalances in neurochemicals – since those with FM are hypersensitive to even the slightest stimuli. They often have a pain response to normally non-painful pressure or activity. It’s not out of the question that a combination of psychological and physical triggers can result in the onset of many of FM symptoms.
Chiropractors often offer their skills to FM patients, hoping to relieve some of their symptoms. In fact, evidence suggests that those with FM consult with chiropractors quite regularly. According to a study conducted at a tertiary Mayo Clinic, 37% of the 300+ FM patients surveyed had visited a chiropractor in the previous 6 months.
But does chiropractic work for them? Some recent studies indicate it does. In one example, chiropractors surveyed FM patients before, during and after a series of treatments to see if they responded favorably to chiropractic adjustments combined with a specific soft tissue technique known as ischemic compression. In this preliminary study, 60% of the subjects who were treated with this protocol experienced a significant improvement – with respect to pain reduction, improved sleep and decreased fatigue. What was especially encouraging was the improvements were reported to be maintained in a 1-month follow up.3 Although pure scientific research on the chiropractic treatment of fibromyalgia is lacking, some early studies are showing that chiropractors could help improve these patients’ quality of life.4 Chiropractors are trained as neuromusculoskeletal specialists, and one of the main focuses of chiropractic care is the positive effects it can have on a person’s nervous system. Since all information from the outside world is collected and analyzed by the nervous system, it’s logical to assume that if a person with FM is sensitive to a stimulus that others are not, there may be something wrong with this system.
Vertebral subluxations are focal areas of spinal restriction and/or malposition. When present, these lesions can not only irritate the nerves that exit the spine (peripheral nervous system), but the irritation caused by subluxations will also feed back into the brain (central nervous system). Information from the joints of the spine is passed on to an important structure in the brain called the cerebellum. This part of the brain has been known traditionally to be important for body awareness, balance and coordination. However, more recent studies have shown the cerebellum to be intimately involved with maintaining proper cognitive function and playing a significant role in emotional stability. Therefore, irritation of the joints in the spine caused by vertebral subluxation may be linked to any of the symptoms associated with fibromyalgia.
More studies are needed to show the positive effects that chiropractors can have with FM patients. However, having chiropractic care alongside other traditional treatment methods (including exercise, massage techniques and cognitive behavioral therapy5) is likely to give these patients a better chance for recovery.
It is also important to note that not all chiropractors are the same and treatment can be quite varied. This is the same with Medical Doctors to some extent. To put it in the proper context, if you tried one Medical Doctor and you didn’t like them or what they did would you never go back to another Medical Doctor again? Most would say no to that. However, many people try chiropractic, not chiropractors. So, if you have gone to only one or a few chiropractors and he or she didn’t help you, consider trying another one. This is especially true with Fibromyalgia. I have done extensive research with Fibromyalgia and one of the main things to consider in treating a patient is their capacity to accept treatment. If you do too much with a Fibromyalgia patient ,either later that day or the next day they will feel like they have been run over by a truck. However, if you treat them within their capacity they will show continual improvement. Often I will have a patient come back in after their first treatment stating that they slept extremely well the night after their treatment. This is exciting to the patient because they are finally getting the rest they need and it is exciting to me because I know that their body is finally beginning to heal.
Quote of the Week
“We are indeed much more than what we eat, but what we eat can nevertheless help us to be much more than what we are.”
- Alice May Brock
References and Sources:
1. Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L: The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995, 38: 19-28.
2. Wahner-Roedler DL, Elkin PL, Vincent A, Thompson JM, Oh TH, Loehrer LL, Mandrekar JN, Bauer BA: Use of complementary and alternative medical therapies by patients referred to a fibromyalgia treatment program at a tertiary care center. Mayo Clinic Proc 2005, 80: 55-60.
3. Hains, G & Hains F. A combined ischemic compression and spinal manipulation in the treatment of fibromyalgia: a preliminary estimate of dose and efficacy.
J Manipulative Physiol Ther 2000, 23(4): 225-230.
4. Blunt KL, Rajwani MH & Guerriero RC. The effectiveness of chiropractic management of fibromyalgia patients: a pilot study. J Manipulative Physiol Ther 1997, 20(6): 389-399.
5. Schneider M, Vernon H, Ko G, Lawson G, Perera J. Chiropractic management of fibromyalgia syndrome: a systematic review of the literature. J Manipulative Physiol Ther 2009, 32(1): 25-40