Fibromyalgia may be one of the more common, yet least understood, conditions that chiropractors encounter in their practice. It was originally thought to be an autoimmune condition, but so far, researchers have not been able to find any evidence to support that theory.
While fibromyalgia may not have a proper etiology, its symptoms are all too real for many patients. How can chiropractors best diagnose and treat this baffling condition?
Causes and symptoms
Although doctors are not certain as to the direct causes for fibromyalgia, it may be due to genetics, physical or emotional trauma, obesity, infections, or other illnesses that may have an autoimmune component, such as rheumatoid arthritis or lupus.
The prevalence for fibromyalgia in the general population is approximately 2 percent, and it is higher for women than for men (3.4 percent versos 0.5 percent).
Patients with fibromyalgia have generalized pain symptoms that may be hard to localize, and their neural processing of pain is abnormal.
These patients also find certain stimuli painful that are not painful for most other people.
Fibromyalgia patients may have a variety of other symptoms, including:
- Morning stiffness
- Tingling or numbness in hands and feet
- Headaches, including migraines
- Irritable bowel syndrome
- Sleep disturbances
- Cognitive problems with thinking and memory
- Painful menstrual periods and other pain syndromes
Standard treatment includes pain relievers, antidepressants, and anticonvulsants. Patients may also be taught self care techniques to handle stressful situations that might exacerbate symptom flareups.
Chiropractic treatment
Due to the generalized nature of pain in fibromyalgia, patients may benefit from trigger point therapy that delivers high thrust at a low force, such as with an instrument adjusting device. This allows patients to gain the maximum benefit from treatment without risking any unnecessary additional pain.
An article in the December 2008 issue of Clinical Chiropractic randomized 53 patients to receive either instrument adjustments for upper trapezoid trigger points (27 patients) versus compression therapy (26 patients). Although all patients improved, 41 percent of the patients who underwent instrument adjustments reported lower pain levels as compared to 36 percent of those who underwent ischemic pressure therapy.
Given that patients with fibromyalgia often report pain in the trapezoids, instrument adjusting may be a useful trigger point therapy method to treat localized flareups of pain associated with the condition.
References
Dellwo A. “Is fibromyalgia an autoimmune disease?” About.com. http://chronicfatigue.about.com/od/whatisfibromyalgia/f/fibroautoimmune.htm. Updated May 2014.
Accessed July 2014.
Mayo Clinic Staff. “Fibromyalgia.” Mayo Clinic. http://www.mayoclinic.org/diseasesconditions/
fibromyalgia/basics/causes/con20019243. Updated February 2014. Accessed July 2014.
Centers for Disease Control and Prevention. “Fibromyalgia.” CDC.gov. http://www.cdc.gov/arthritis/basics/fibromyalgia.htm#2. Updated November 2012. Accessed July
2014.
Allen A, Gemmell H. “Relative immediate effect of ischaemic compression and activator trigger point therapy on active upper trapezius trigger points: A randomized trial.” Clinical Chiropractic 2008, 11(4):175–81.
