Fibromyalgia: Are Chiropractic Adjustments Appropriate?
Fibromyalgia: Are Chiropractic Adjustments Appropriate?
John C. Lowe, M.A., D.C.
Chiropractor
SpineUniverse.com

Fibromyalgia is an epidemic and disabling myofascial condition. The typical patient says he hurts all over, sleeps poorly, and feels chronically tired and depressed. Some DCs who are IMEs assert that chiropractic treatment isn't proper for these patients. One notorious Oregon IME wrote to me after reading some of my articles on myofascial therapy. He objects, he said, to DCs giving fibromyalgia patients series of spinal adjustments; so he tells insurance companies to disallow chiropractic claims for treatment of these patients.


I didn't react favorably to the IME's view. I'd just completed a year-long study that suggests his objection is nonsense. In the study, I repeatedly adjusted a subject's C5-C6 cervical segments. This dramatically reduced the irritability of her infraspinatus trigger points. (1) (The infraspinatus, of course, is innervated by C5-C6.)

The irritability of my subject's trigger points reduced gradually -- under the influence of a series of cervical adjustments. We found that the more frequent the adjustments, the more dramatic the relief from trigger point irritability. This study has an important implication: Repeatedly adjusting any fixated part of the spine may reduce the irritability of trigger points in muscles innervated by that part of the spine.

This corresponds to what I've seen in many fibromyalgia patients I've repeatedly adjusted. Chances are this Oregon IME hasn't watched how fibromyalgia patients respond to repeated adjustments. Otherwise, he wouldn't be hassling his fellow DCs for providing this service. In contrast to this IME, others outside our discipline appreciate the value of chiropractic care for fibromyalgia patients.

For example, respected rheumatologist Dr. Frederick Wolfe points out that chiropractic treatment helps these patients. Dr. Wolfe is a well-known investigator of fibromyalgia, and is clinical professor, Department of Medicine, University of Kansas School of Medicine. In 1985, he and his colleagues interviewed 81 fibromyalgia patients and 81 control subjects using a structured questionnaire. (2)

Wolfe wrote,(2 p.13) "In our current series, we asked patients to indicate if a drug or treatment had reduced their pain ... Of interest is that patients reported more benefit from 'life-style' modifications such as rest and relaxation than from other interventions. Chiropractic treatment also scored among the most effective measures" (emphasis mine).

In 1991, I talked with Dr. Wolfe about his study. (3,4) He reminded me that he used a questionnaire to elicit answers from fibromyalgia patients. "And what we reported," he told me, "is what they said -- not whether in fact it was true. It's sort of like asking people whether they took a vitamin and it made them feel better. Fifty percent of people might say yes, but that's an association rather than a causal relationship."

I asked about chiropractic rating among the most effective measures. "Yes," he answered, "I think that's actually a very useful comment in that ... see, that's a different kind of statement. One could

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