Fibromyalgia (FM) is a very common condition that affects approximately 3-6% of the world population. A partial list of symptoms associated with FM includes widespread pain, fatigue, non-restorative sleep, generalized stiffness, memory problems, poor balance, headache, numbness/tingling, painful muscle cramps/spasms, depression, anxiety, back pain, jaw pain, and hypersensitivity to noise, lights, odors (perfumes), and weather changes. It is important to note that FM is NOT a psychiatric disorder and can it be diagnosed and treated, though promising a cure is not realistic.
There are many websites and articles that one can access through the internet. This is not an endorsement for any one site but rather, a review of one site that is available. The “Fibromyalgia Information Foundation” (www.myalgia.com) offers a lot of information that is very informative and usable. The site includes information on the condition, the diagnosis, treatment, exercise advice, and more. For example, under “Treatment of FM,” it is stated that there is no “cure” for FM. Rather, the goal of treatment is to teach the patient to gain “control” over the condition rather than to have the condition control the patient. There are four major areas of treatment to concentrate on which include pain management, exercise, sleep, and psyche. For pain management, there are lists of different medications, manual therapies, and physical agents that can be of benefit to the FM patient. Exercise is emphasized to be gentle stretching after warming up and not to exercise too aggressively, so as to avoid irritation. In addition to stretching, light non-impacting aerobic exercise such as walking, water exercises, and/or stationary bike are recommended with a gradual increase in dose. Starting out at short 3-5 minute sessions, 2-3 times per day and gradually increase the session duration to three, 10 minute sessions/day, then to 2 -15 minute sessions and eventually one 20-30 minute session/day may be wise.
Regarding sleep, all FM patients complain of interrupted, non-refreshed sleep and improving this pattern is important. If an underlying condition such as whiplash, back, neck, or shoulder pain is the cause of interrupted sleep, that condition should be managed. A sleep study to determine if sleep apnea is an issue and the use of a C-pap unit can be quite helpful in gaining restorative sleep. Regarding the “psyche”… Because chronic pain can result in depression, anger, fear, withdrawal, and anxiety, management of these issues is important. Early detection and treatment is ideal. Interventions can include activity management such as ergonomic modifications both at work and home such as weight lift/carry limits, computer station re-design, the use of headsets vs. phones, and modifying other irritating postures should be considered. A de-emphasis of medications and long-term health care provision without clear goals is important. Unless an underlying psychological condition is present, counseling may be non-productive. However, biofeedback and some behavior modification may benefit some patients that are having trouble coping with the pain and its effect on their lives.
Chiropractic is an important player in the management process of FM and benefits the patient by helping them set realistic goals and offering management strategies to help achieve those goals. Patients with FM need a “quarterback” to guide them in this process for which chiropractic is a logical choice.
