Fibromyalgia Syndrome

Hi Everyone,

I see a fair number of fibromyalgia patients in my office. One patient has been bugging me for a couple of years to put some of this information on the internet. Well, here it is.

Since fibromyalgia is a symptom based diagnosis, the treatment plan can vary a bit from person to person. Fibromyalgia is not diagnosed based on the cause of the symptoms, but rather on the symptoms themselves. This means that there could be several treatments that work for different people because the cause might not be the same. The cause is still debated in the health care world, but several sound theories are being looked into. Until the cause of fibromyalgia is defined more clearly, the treatment needs to be based on each individual.

I have read many studies on this problem, and today I found two studies I hadn’t read before. I was unable to find links to some of the other information I have come across in the past. Before I share the studies today, I’d like to share some more information.

Some possible causes of Fibromyalgia syndrome (FMS) or Fibromyalgia (FM) include stress, lack of certain vitamins and minerals, and a lack of or imbalance in some neurotransmitters (such as norepinephrine and serotonin). There are other ideas out there, these are just a few.

I like to start with lifestyle changes. Are you getting enough water, vitamins, and minerals? Are you exercising on a daily basis? Are you doing something everyday to relax? All of these things can decrease symptoms of FM.

Heart and cardiovascular issues as well as sleep issues can also be a problem in people with FM. Dealing with these issues can also help symptoms. For some people a visit with a cardiologist or a sleep study might be helpful to rule out heart problems, sleep apnea, or hypopnea.

Digestive issues like IBS (irritable bowel syndrome) and other digestive problems are common in people who have FM. Allergies and food sensitivities can contribute to symptoms of FM. It is important to rule out any digestive abnormalities. Managing digestive problems will help with the FM symptoms.

Depression, anxiety, and other psychological issues are common in fibromyalgia patients. These issues, like cardiovascular, digestive, and sleep disorders, should be dealt with. Getting help from a psychologist is not something to be embarrassed about. Many people try to avoid the possibility that stress and other psychological influences could be affecting their physical pain. Finding out if some of the physical pain can be helped with stress reduction and counseling is an important part of care. There are very real physical results that manifest due to what we are thinking.

Chiropractic treatment, aerobic exercise, strength training, acupuncture, Qi Gong, and nutritional supplements (especially Magnesium, EPA, and DHA) can all be helpful in treating fibromyalgia. The difficulty is in finding the right combination of treatments to help each individual with fibromyalgia to feel better. Patients I have worked with have found that chiropractic care as well as massage, acupuncture, Pilates, yoga, tai chi/qi gong, ball rolling, aerobic exercise, relaxation, meditation, diet changes, and nutritional supplements all to be helpful. Not every patient does all of the above, but different combinations of the above. FM patients need to give their doctors enough time to run through trial treatments of various combinations of things that we know will help. Too often a patient gives up on care without trying all of the different combinations of treatments available, or don’t follow doctor’s instructions. Find a doctor you trust, and stick with it. It takes time to find a treatment plan that works for any given person with FM.

There are also medications that can be helpful, but as a chiropractor those are out of my legal scope of practice.

http://www.chiroindex.org/?search_page=articles&action=&articleId=16610 –This study finds that chiropractic care can be helpful for fibromyalgia patients.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1779399/?tool=pmcentrez –This study is a medical study, and so it is heavy on the drug treatments. It didn’t look like it mentioned chiropractic. It did, however, find that exercise, acupuncture, nutrition, and Qi gong can be helpful.

In the past I have read that 20 min. of aerobic exercise (huff and puff you could talk but you don’t feel like it exercise) daily, can significantly decrease symptoms of FM. The above study says 20 min. two times a week will do. The above study also mentions strength exercise is helpful as well.

Clearly, the best treatment for Fibromyalgia is a multi-level plan of care. It is my opinion that the best results come when the different health care specialties can work together to manage the problems that come with FM. Chiropractors usually have great results in treating FM symptoms.

Hope you all have a wonderful day!

Sincerely,
Dr. Gwen
(Gwendolyn E. Kelly-Kohnke, D.C.)