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Fibromyalgia is a condition that is increasing in prevalence. It is a difficult condition to diagnose definitively for a number of reasons. There are no clear pathological laboratory tests that can demonstrate the existence of fibromyalgia. The diagnosis must therefore be made clinically. This is also difficult because fibromyalgia shares many of its diagnostic indicators with a number of other non-specific disorders such as chronic fatigue syndrome and irritable bowel syndrome. These indicators include sleep disturbances, digestive disorders, anxiety and fatigue. The fatigue is thought to be caused by a fibromyalgia sufferer being unable to reach the restful state of REM sleep that is necessary for healing and repair.
Currently, the best indicators of the existence of fibromyalgia include widespread pain and tenderness over a chronic timeframe (greater than 3 months). The pain is usually felt in both sides of the body, as well as both above and below the waist. Males tend to experience the condition less than females, who have a predominance of around 9:1.
Once diagnosed, the challenges facing a fibromyalgia sufferer are far from over. There are no known cures for the condition at the present time. Conventional medical treatment has included pain killing medication and anti-depressant medication. While these may produce limited symptomatic improvement, the side effects of weight gain and generalised lethargy make them a less attractive option. Exercise and cognitive behavioural therapies have been combined with complementary health care approaches with greater success as treatment options.
The role of stress is becoming increasingly acknowledged in the mechanisms of fibromyalgia. Stress has a number of effects on the central nervous system which can increase perceptions of pain.
Exercise, cognitive behavioural therapies and complementary health care are effective methods for dealing with stress and therefore provide a valuable contribution to the management of fibromyalgia. Studies have shown that when the patient accepts that there is a psychological component to the condition, they tend to get a better outcome. This makes perfect sense in complementary health care models which view a person as a holistic entity including a mind and body working together.
Chiropractic care is one such model. The relationship between movement of the spine, (and other joints including the feet) and proprioceptive input into the central nervous system is one of the central concepts of chiropractic. Chiropractors use spinal adjustments to restore movement and functional alignment to spinal structures. Combining this with exercise programs that are within the tolerance of a person with fibromyalgia can produce clinical benefits.
Terhorst L, Schneider MJ, Kim KH, Goozdich LM, Stilley CS. Complementary and alternative medicine in the treatment of pain in fibromyalgia: a systematic review of randomized controlled trials. Journal of Manipulative and Physiological Therapeutics 2011; 34(7): 483-496.