Fibromyalgia

FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME - Is there a difference?

The problems of Chronic Fatigue Syndrome and Fibromyalgia have become epidemic. The Centers for Disease Control estimates at least 500,000 people have Chronic Fatigue Syndrome while the American College of Rheumatology reports over 7 million women and about 700,00 men have Fibromyalgia. It is well known that long-term chronic fatigue and pain can have a sever impact on quality of life. In addition to physical limitations, it often leads to irritability, anxiety and depression.

FIBROMYALGIA SYNDROME

WHAT IS FIBROMYALGIA SYNDROME?

FMS (fibromyalgia syndrome) is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Fibromyalgia means pain in the muscles, ligaments and tendons--the fibrous tissues in the body. FMS used to be called fibrositis, implying that there was inflammation in the muscles, but research later proved that inflammation did not exist.

Most patients with fibromyalgia say that they ache all over. Their muscles may feel like they have been pulled or overworked. Sometimes the muscles twitch and at other times they burn. More women than men are afflicted with fibromyalgia, but it shows up in people of all ages.

To help your family and friends relate to your condition, have them think back to the last time they had a bad flu. Every muscle in their body shouted out in pain. In addition, they felt devoid of energy as though someone had unplugged their power supply. While the severity of symptoms fluctuate from person to person, FMS may resemble a post-viral state and this is why several experts in the field of FMS and CFS believe that these two syndromes are one and the same

Chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is a complicated disorder characterized by extreme fatigue that doesn't improve with bed rest and may worsen with physical or mental activity. Of all chronic illnesses, chronic fatigue syndrome is one of the most mysterious. Unlike infections, it has no clear cause. Unlike conditions such as diabetes or anemia, there's essentially nothing to measure. And unlike conditions such as heart disease, there are relatively few treatment options.

Chronic fatigue syndrome may occur after an infection such as a cold or viral syndrome. It can start during or shortly after a period of high stress or come on gradually without any clear starting point or any obvious cause. Chronic fatigue syndrome is a flu-like condition that can drain your energy and sometimes last for years. People previously healthy and full of energy may experience a variety of symptoms, including extreme fatigue, weakness and headaches as well as difficulty concentrating and painful joints, muscles and lymph nodes.

Women are diagnosed with chronic fatigue syndrome two to four times as often as men are. However, it's unclear whether chronic fatigue syndrome affects women more frequently or if women report it to their doctors more often than men do.

Source; Mayo Clinic

Do you want a Nutritional approach to this problem?

Is Chiropractic a Treatment for this Disease?

Increased rates of fibromyalgia following cervical spine injury: A controlled study of 161 cases of traumatic injury. Buskila D, Neumannn L, Vaisberg G, Alkalay D, Wolfe F. Arthritis Rheum 1997;40:446-452.

In this Israeli study it was revealed that adults with neck injuries had a 13-fold increased risk of developing fibromyalgia within 1 year of their injury compared with adults with lower extremity fractures.

Trauma and fibromyalgia: is there an association and what does it mean? White KP, Carette S Seminars in Arthritis & Rheumatism 29(4):200-216, 2000. There is some evidence supporting an association between trauma and fibromyalgia. More research is needed.

Upper cervical management of primary fibromyalgia and chronic fatigue syndrome cases. Amalu WC. Today�s Chiropractic May/June 2000 Pp.76-86. This is a paper of 23 successive cases (5 male, 18 female from 11 to 76 years of age) of primary fibromyalgia and chronic fatigue syndrome suffering from 2 to 35 years. Total care visits ranged from 20 to 48. All patients reported maintaining their improvements at 1 to 1 � years or more of follow up. After care every patient was ale to resume normal activities including full time work. The author writes �Improvement in symptoms of 92-100% was achieved in both these syndromes subsequent to corrections of aberrant arthrokinematic function of the occipito-atlanto-axial complex�A causal relationship between biomechanical faults in the upper cervical spine, abnormal central neurophysiologic processing and subsequent peripheral neuropathophysiology, is suggested as the possible genesis of these two syndromes.�

The clinical syndrome of fibrositis. Wolfe F, American Journal of Medicine 1986 Vol. 81 (suppl 3A) Sept 29, 1986; 7-14

Researchers found that 45.9% of people who had fibromyalgia and went to a chiropractor experienced moderate to great improvement. In the same study, anti-depressant medication benefited only 36.3% of those studied and exercise was limited to a 31.8% rate of improvement.

Combined ischemic compression and spinal manipulation in the treatment of fibromyalgia: a preliminary estimate of dose efficacy. Hain S and Hain F. Journal of Manipulative and Physiological Therapeutics Vol 23 No. 4 May 2000 pp.225-230.

In this study of 15 women with fibromyalgia , 60% (9) responded very well to Chiropractic Care meaning they had at least a 50% reduction in pain symptoms. The patients in the study had fibromyalgia for more than 3 months and were adult members of a regional Fibromyalgia Association. Each participant was adjusted during 30 visits with self-administered assessments taken at the beginning of the study, after 15 visits, 30 visits and 30 days after completion of the study. Researchers were looking for improvement in three areas; pain intensity, fatigue level and sleep quality. The improvement in all three areas continued after 1 month without chiropractic care.

Note from Dr. Koren: The quality of chiropractic care in this study was poor. Patients were adjusted twice a week whether they needed it or not. �Adjustments� (really manipulations) were rotary diversified to the neck and thoracic. I can only wonder what the results would have been if specific, scientific spinal adjustments were administered.

The effectiveness of chiropractic management of fibromyalgia patients: a pilot study. Blunt KL, Rajwani MH, and Guerriero RC. J Manipulative Physiological Therapy; 1997: 20(6):389-99.

Twenty-one rheumatology patients aged 25-70 suffering from fibromyalgia (muscular pain characterized by muscular tautness/stiffness, well-defined tender/trigger points, numbness, tingling, and pain) were studied to demonstrate chiropractic�s effect on this condition. Chiropractic care consisted of 4 weeks of spinal care plus soft tissue and passive stretching at the chiropractors� discretion. Chiropractic management improved patients� cervical and lumbar ranges of motion, straight leg raise and reported pain levels.

Prospective, longitudinal study of service utilization and costs in fibromyalgia. Wolf F. Anderson J, Harkness, D et al. Arthritis and Rheumatism, 1997; 40, pp.1560-70.

In this study of 538 fibromyalgia patients it was revealed that chiropractors were one of the more common health care professionals visited by patients, averaging 30.4 visits per 100 patients (per six-month period).

Chronic Fatigue Syndrome

Chronic fatigue syndrome update. Findings now point to CNS involvement Postgraduate medicine. Vol. 96, No. 6 November 1994.

From the Preview: Abnormalities of immune function, hypothalamic and pituitary function, neurotransmitter regulation, and cerebral perfusion have been found in patients with the syndrome. Dr. Bell summarizes and discusses the implications of these and other findings. One of Dr. Bell�s more interesting points was that there is some form of �immune system activation or immune system dysfunction.� The cause of this altered immunological state remains elusive. Vertebral subluxation complex perhaps?

Upper cervical management of primary fibromyalgia and chronic fatigue syndrome cases. Amalu WC. Today�s Chiropractic May/June 2000 Pp.76-86.

This paper discusses 23 successive cases (5 male, 18 female from 11 to 76 years of age) of primary fibromyalgia and chronic fatigue syndrome suffering from 2 to 35 years. Total chiropractic visits ranged from 20 to 48. All patients reported maintaining their improvements at 1 to 1 � years or more of follow up. After care every patient was able to resume normal activities including full time work. The author writes: �Improvement in symptoms of 92-100% was achieved in both these syndromes�A causal relationship between biomechanical faults in the upper cervical spine, abnormal central neurophysiologic processing and subsequent peripheral neuropathophysiology, is suggested as the possible genesis of these two syndromes.�

Effective treatment for chronic fatigue syndrome. Case studies of 70 patients. Farinelli, EJ, Proceedings of the 1989 International Confer3ence on Spinal Manipulation. March 31-April 1, 1989. Washington, DC.

Patients were put in one of 4 experimental groups: Group A was treated under the medical model which assumes a viral cause of Chronic Fatigue. They followed a six-month regimen designed to strengthen the immune system through the use of specific digestive enzymes, therapeutic herbs, vitamins, and trace minerals. Improvement in group A was temporary. Group B followed the same regimen and also received diversified chiropractic treatment. All patients improved only temporarily. Group C followed the same regimen and also received upper cervical specific adjustments at C1-C2. All patients improved and, at six months follow up, reported complete relief from Chronic Fatigue symptoms. Group D received upper cervical adjustments only. Ten out of ten patients recovered permanently from Chronic Fatigue symptoms..

Progress study on chronic fatigue syndrome (CFS) study. Woodfield, C. Abstracts from the 14^th annual upper cervical spine conference Nov 22-23, 1997 Life University, Marietta, Ga. Pub. in Chiropractic Research Journal Vol. 5, No.1, Spring 1998. P. 42.

This study involves 20 patients who had no prior history of depression and fulfilled the Centers for Disease Control and Prevention definition of chronic fatigue syndrome. The adjustment used is NUCCA. There have been two CFS patients who have completed several aspects of the procedure�SF-36 scores on these two patients after chiropractic correction show very promising results.

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