Chiropractic for Treating Fibromyalgia
A combination of chiropractic, trigger point therapy, and lifestyle changes has proven to be very effective in decreasing the severity and duration of the physical pain of fibromyalgia.
The word fibromyalgia comes from the Latin term for fibrous tissue (fibro) and the Greek ones for muscle (myo) and pain (algia). Fibromyalgia syndrome is chronic disorder which includes widespread muscle pain, fatigue, and multiple tender points that affects 3-6 million people in the United States. For reasons that are unclear, more than 90% of those who develop fibromyalgia are women.
According to the American College of Rheumatology (ACR), fibromyalgia is defined as a history of pain in all four quadrants of the body lasting more than 3 months. Pain in all four quadrants means that you have pain in both your right and left sides, as well as above and below the waist. The ACR also described 18 characteristic tender points on the body that are associated with fibromyalgia. In order to be diagnosed with fibromyalgia, a person must have 11 or more tender points. In addition to pain and fatigue, people who have fibromyalgia may experience:
- Sleep disturbances
- Morning stiffness
- Irritable bowel syndrome
- Painful menstrual periods
- Numbness or tingling of the extremities
- Restless legs syndrome
- Temperature sensitivity
- Cognitive and memory problems (sometimes referred to as “fibro fog”)
Fibromyalgia is often confused with another condition called “myofascial pain syndrome” or “myofasciitis.” Both fibromyalgia and myofasciitis can cause pain in all four quadrants of the body and tend to have similar tender point locations, but the two conditions are worlds apart. Myofasciitis is an inflammatory condition due to overuse or injury to your muscles, whereas fibromyalgia is caused by a stress-induced change in metabolism and healing. Myofasciitis tend to come on rather suddenly and is usually associated with a particular activity or injury. True fibromyalgia has a slow, insidious onset, usually beginning in early adulthood. It is very important to diagnose each of these correctly, for they require very different approaches to treatment. Unfortunately, fibromyalgia is a chronic condition, meaning it lasts a long time – possibly a lifetime. However. it won’t cause damage to your joints, muscles, or internal organs.
The Basics of Fibromyalgia
Do you feel sick and tired and achy all of the time? Is the pain worse in the morning, often with increased muscle stiffness? Do you feel fatigued every day, even after a full night’s sleep? Do you have restless sleep, insomnia, headaches, irritable bowel syndrome or other digestive or elimination problems, terrible premenstrual syndrome, chest pain, nervousness or excessive stress, an intolerance to cold or damp weather? Do you feel anxious or experience heart palpitations, feel depressed or suffer from chronic fatigue syndrome? Are you frustrated that no one has been able to help you? With all of your medical tests giving normal results, you may even begin to wonder if any of it is real. What I’ve just described is VERY REAL, but little understood condition which is neither disfiguring nor life threatening. It is called fibromyalgia: ‘fibro’ meaning fibrous and connective tissue; ‘my’ meaning muscle tissue; and ‘algia’ meaning pain. This pain syndrome is not specifically a disease, but rather a grouping of symptoms. It wasn’t until 1990 that specific criteria for the diagnosis for fibromyalgia were developed. What many doctors have been diagnosing and treating as arthritis, sleep disorder and depression may actually be fibromyalgia. Associated conditions often associated or complexed with fibromyalgia are: Chron’s Disease or Irritable Bowel Syndrome, Migraine Headaches, PMS, thyroid disease and some skin diseases such as chronic eczema or psoriasis. As you read on you’ll find that simply treating all these conditions as though they are separate entities simply doesn’t work. While one symptom may improve with a certain medical (medication) treatments, the others often worsen.
For years none of the published literature by either researchers or medical doctors have recognized no known cause for fibromyalgia. Although there are many different theories, some pointing to an initiating illness or parasitic infection, others believe a trauma (either physical or emotional) can be the precipitating event or cause. Other theories indicate rheumatoid arthritis, genetic predisposition, low blood flow to a particular part of the brain, increased substance P in the spinal cord and reduced mitochondrial production of ATP. However, each sufferers’ history, onset and genetic make-up is so different, a common cause has still not been identified.
My experience with fibromyalgia patients has been no different. One patient may identify the onset being related to a bout with an illness such as Mono or Strep. Another patient may relate the onset with a fall, physical injury, car accident, or child birth, and another will not be able to identify a specific onset at all.
The common thread I have found in the majority of patients I’ve helped with fibromyalgia is that the condition was really building for a very long time, and the triggering event is really the proverbial straw that broke the camel’s back. A long history of allergies or digestive complaints is often evident. In some cases the downward spiral started in very early childhood with many illnesses such as ear infections or allergies and the prescribing of antibiotics. Other times a slow build in digestive complaints like heart burn or constipation and the use of anti-acids and acid inhibitors really spurs on the descent into illness. While the stories vary somewhat, that common thread of untreated or improperly treated illness seems to always stand out for me.
There are no specific tests to identify fibromyalgia. Patients who undergo a battery of tests are often told that all the findings were normal. The diagnosis is often made by identifying some specific symptoms and ruling out other disorders. The presence of pain and aches all over the body, along with fatigue and having at least 11 of 18 tender points are used to diagnose fibromyalgia.
Fibromyalgia can be difficult to treat. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach, utilizing chiropractic care, trigger point therapy, massage, functional medicine (specific nutritional support), and Acupuncture, as well as exercises and stretching.
Treating Fibromyalgia with Chiropractic
I have found that a combination of treatment methods seem to elicit the best responses. These include dietary changes and specific nutritional support, removal of food allergens and toxic chemicals, chiropractic adjustments, and or acupuncture treatments. Of course stress management is a must do. If needed, physio therapies (electrical muscle stimulation, ultrasound, ice, heat and myofascial release) may also be used to reduce pain and inflammation, and exercise may be prescribed to boost feel good hormones and enhance detoxification.
Chiropractic care is critical for those who suffer from fibromyalgia in order to keep the spine and muscles from losing too much movement. Because fibromyalgia causes the muscles to tighten up and lose some of their natural pliability, it results in a global loss of movement in the spine. The loss of movement in the spine results in a neurological reflex that causes the muscles to tighten further. This vicious cycle will continue and over time will lead to increased pain, increased muscle tightness, a loss of movement, more difficulty sleeping and the development of more and more trigger points.
The only option is to continually adjust the spine and keep it moving. It is not uncommon for those with fibromyalgia to be adjusted three to four times per month to keep everything mobile and relaxed. The biggest concern in treating people with fibromyalgia is that their muscles have a diminished healing ability. For this reason, Dr. Hoch typically combines chiropractic adjustments with other therapies and specific nutritional support to improve healing of the muscles. Your adjustments may also be modified or made gentler to prevent stress on the ligaments and muscles. This helps to decrease the stress on all of the small supporting muscles of the spine, which can be easily injured. It is important when seeking chiropractic care, to make sure that the doctor is familiar with the muscular changes that occur with fibromyalgia so that they can adjust their treatment accordingly.