Fibromyalgia: Chiropractic Management

Fibromyalgia (FM) is a very common cause of chronic pain and fatigue. It’s plagued with the combination of not knowing what causes it (in many cases) and, the fact that very few treatments seem to work. Also, patients often relay information about a “bad experience” with a doctor who down plays the diagnosis or worse, outwardly denies that it even exists! This makes it all the more challenging for the patient who is simply just trying to find answers as to how to manage living with this condition.

Chiropractic offers the patient a “quarterback” or, someone who can coordinate care (when needed) from different health care providers, as well as offer the patient a very effect treatment option. In one study, chiropractic spinal manipulation was used in conjunction with ischemic compression with results measured by tracking pain, fatigue levels and sleep quality by the use of validated questionnaires completed by the patient. In this 24 FM patient trial (members were recruited from a regional Fibromyalgia Association group), the subjects had symptoms for >3 months, and a total of 30 treatment were performed. After the first 15 treatments, about 2/3rds of the subjects reported significant improvement (questionnaire score improvements of at least 50%) in the pain, fatigue and sleep quality! Even better, after 30 treatments, there was a 77% reduction in pain intensity, 64% improvement in sleep quality, and 75% reduction in fatigue level scores. Moreover, these improvements were maintained even a month after treatment ended. Also, they found that subjects with less than 35% improvement after 15 treatments did not have a satisfactory response after the 30 treatments. A trend (though not statistically significant) suggested that older subjects with more severe symptoms and chronic pain tended to do have a greater number of tender points, and responded more poorly to treatment. The conclusion reported this favorable response deserves a larger scaled study.

So, what you can expect when you arrive for treatment? The first “order of business” is to obtain your health history, paying particular attention to your specific treatment goals. This is also the time when we review your daily activities and quantify your activity tolerance so we can properly compare your current (baseline) level of function to future re-evaluations. Part of the assessment may include measuring your physical performance, although that entirely depends on your level of function at the time of the initial examination. Usually, after 2-3 treatments and after reviewing your response to the treatments, we will begin incorporating home-based exercises or if you’re already exercising, augment your current program. These exercises may include stretching, core stabilizing strengthening exercises, balance training, aerobic exercises, and others. Depending on your confidence with exercise and, of course, your goals, other forms of exercise may also be recommended such as yoga, Palates, water exercises, health club programs, and/or others. We may recommend various modalities such as electric stimulation, ultrasound, pulsed magnetic stimulation, low level laser therapy, class IV laser therapy, and/or others. A massage therapist may also be considered as part of your “management team.” Coordination of care with your primary care physician is also important. Nutritional counseling can also be highly effective and may include an anti-inflammatory diet such as a low gluten diet, and specific vitamin recommendations may include a multiple vitamin mineral, magnesium, calcium, omega 3 fatty acids, vitamin D, and/or CoQ10 (anti-oxidant). Most important is that we can facilitate as a “quarterback” with your other personal management strategies.