Fibromyalgia Improvement has been

Linked to Chiropractic Care

A report on the scientific literature 


By: Mark Studin DC, FASBE(C), DAAPM, DAAMLP

William Owens DC, DAAMLP, CPC

According to the Mayo Clinic:

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event. Women are much more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression. While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.

 

 

Symptoms Include:

 

  • Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain must occur on both sides of your body and above and below your waist.
  •  People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders, such as restless legs syndrome and sleep apnea.
  • Cognitive difficulties. A symptom commonly referred to as "fibro fog" impairs the ability to focus, pay attention and concentrate on mental tasks.
  • Other problems. Many people who have fibromyalgia also may experience depression, headaches, and pain or cramping in the lower abdomen.

(http://www.mayoclinic.org/diseases-conditions/fibromyalgia/basics/symptoms/con-20019243)

 

By Mayo Clinic’s own admission, medicine has no solution for fibromyalgia patients when they report that these case are to be managed and further report that the management includes pain medication, antidepressants, anti-seizure drugs and psychotherapy. None have a cure, but all (except the psychotherapy have side effects.

 

 

In order to fully understand the effects of the spinal adjustment on the function and potential disease processes, we must first understand there are three primary pathways by which the chiropractic adjustment effects the human body.  These are through biomechanics (local joint fixation and motion), pain management (organized and monitored through sensory input into the dorsal horn of the spinal cord to higher centers in the brain) and the autonomic systems (sympathetic and parasympathetic influences such as blood pressure changes through the endocrine system).

 

It has been well established, as reported by Studin, Owens, and Zolli (2015), that the chiropractic spinal adjustment has a direct and immediate effect on the central nervous system, outlined as part of the “pain management” pathway of the chiropractic spinal adjustment response. Research has shown that the chiropractic spinal adjustment affects the modulation of ascending and descending communication in the central nervous system within the dorsal horn. The adjustment then affects the thalamus and other areas of the brain and has a direct effect on gating pain in both directly treated and disparate regions as a result of the central nervous system connections.  There are ancillary effects within primitive centers of the brain that control anxiety, depression and chronic responses to pain. 

 

Kovanur Sampath, Mani, Cotter and Tumilty (2015) reported that the effects of spinal manipulation (chiropractic spinal adjustments) on various functions of the autonomic nervous system have been well identified in manual therapy literature. They reported “The common physiological mechanism proposed for these autonomic nervous system changes involves possible influence on segmental and extrasegmental reflexes with a prominent role given to the peripheral sympathetic nervous system” They concluded, “…cervical manipulation elicits a parasympathetic response and a thoracic/lumbar SM [spinal manipulation] elicits a sympathetic response” (Kovanur Sampath et al., 2015, p. 2).  

 

In summary, it is evident that spinal manipulation has an effect on the autonomic nervous system though the direction of effect may vary.  While we have spent years observing and studying the effects of the chiropractic spinal adjustment, there has never been an identified direct connection to the higher cortical areas until recently.  The literature, according to Kovanur Sampath et al. (2015), has concluded that there is a direct relationship between the autonomic system and the hypothalamus - pituitary – adrenal gland in chronic pain syndromes including autoimmune diseases such as fibromyalgia, and other maladies. Currently, research is finally linking the neuronal mechanisms involved in pain modulation to the chiropractic adjustment.

 

The key is utilizing the chiropractic spinal adjustment in balancing the autonomic nervous system and in turn helping to rectify the hypothalamus – pituitary – adrenal gland imbalance as a viable treatment modality. In conclusion, it is the neuro-endocrine pathway research that has the ability to bring chiropractic full circle into proving objectively and scientifically what we have observed for 120 years.  We can also never lose sight that these finding are just a beginning, requiring more research and more answers to help providers create more specific treatment plans an offer more options for patients suffering with fibromyalgia and other maladies.

 

As with all of our articles from here forward, I would like to leave you with a last and seemingly unrelated statement.  I felt it was important to add this at the end since many of our critics negatively portray the safety of chiropractic care.  This statement shall put that to rest leaving only personal biases left standing. Whedon, Mackenzie, Phillips, and Lurie (2015) based their study on 6,669,603 subjects and after the unqualified subjects had been removed from the study, the total patient number accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury into normal healthy tissues has been identified” (Whedon et al., 2015, p. 5). This study supersedes all the rhetoric about chiropractic and stroke and renders an outcome assessment to help guide the triage pattern of mechanical spine patients.

 

References:

  1. Fibromyalgia, Mayo Clinic (2016), Retrieved from: http://www.mayoclinic.org/diseases-conditions/fibromyalgia/basics/symptoms/con-20019243
  2. 2.Studin, M., Owens, W., Zolli, F. (2015).Chiropractic, chronic back pain and brain shrinkage: A better understanding of Alzheimer’s, dementia, schizophrenia, depression and cognitive disorders and chiropractic’s role, A literature review of the mechanisms. The American Chiropractor, 37
  3. Kovanur Sampath, K., Mani, R., Cotter, J. D, & Tumilty, S. (2015). Measurable changes in the neuro-endocrine mechanism following spinal manipulation]. Medical Hypothesis, 85, 819-824
  1. Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2015). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-69 years. Spine, 40(4), 264-270.

 

Dr. Mark Studin is an Adjunct Associate Professor of Chiropractic at the University of Bridgeport College of Chiropractic, an Adjunct Professor of Clinical Sciences at Texas Chiropractic College and a clinical presenter for the State of New York at Buffalo, School of Medicine and Biomedical Sciences for post-doctoral education, teaching MRI spine interpretation and triaging trauma cases. He is also the president of the Academy of Chiropractic teaching doctors of chiropractic how to interface with the legal community (www.DoctorsPIProgram.com), teaches MRI interpretation and triaging trauma cases to doctors of all disciplines nationally and studies trends in healthcare on a national scale (www.TeachDoctors.com). He can be reached at DrMark@AcademyofChiropractic.com or at 631-786-4253.

Dr. Bill Owens is presently in private practice in Buffalo and Rochester NY and generates the majority of his new patient referrals directly from the primary care medical community.  He is an Associate Adjunct Professor at the State University of New York at Buffalo School of Medicine and Biomedical Sciences as well as the University of Bridgeport, College of Chiropractic and an Adjunct Professor of Clinical Sciences at Texas Chiropractic College.  He also works directly with doctors of chiropractic to help them build relationships with medical providers in their community. He can be reached at dr.owens@academyofchiropractic.com or www.mdreferralprogram.com or 716-228-3847  

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Published in Neck Problems

Harvard Report Points to Chiropractic Care for Pain Relief

& The Safety of the Chiropractic Adjustment

By

Noah Herbert, D.C., CCSP®

William J. Owens DC, DAAMLP

Mark Studin DC, FASBE(C), DAAMLP, DAAPM

A recent article released by Harvard Health Publications at Harvard Medical School points to chiropractic care as a form of pain relief. There are currently many Americans that seek out chiropractors, but many people don’t realize the wide variety of treatments that a chiropractor can provide for pain relief. The article states “while the mainstay of chiropractic is spinal manipulation, chiropractic care now includes a wide variety of other treatments, including manual or manipulative therapies, postural and exercise education, ergonomic training (how to walk, sit, and stand to limit back strain), nutritional consultation, and even ultrasound and laser therapies. In addition, chiropractors today often work in conjunction with primary care doctors, pain experts, and surgeons to treat patients with pain.”

While this is nothing new for the chiropractic community, it may serve to further educate the public as to the many tools a chiropractor possesses to help patients. While the majority of research on chiropractic has focused on spinal manipulation, or adjustment of the spine, for pain relief, there have been studies done on the effectiveness of chiropractic for treating musculoskeletal pain, headaches, asthma, carpal tunnel syndrome and fibromyalgia (Harvard Health Publications). The author goes on to state “a recent review concluded that chiropractic spinal manipulation may be helpful for back pain, migraine, neck pain and whiplash.” It should be pointed out there have been reports of serious complications, including stroke, but this has been shown to be extremely rare and some studies suggest this may not be directly caused by the treatment provided by the chiropractor (Harvard Health Publications).

Spinal manipulation, or adjustment of the spine, is a term used to describe providing a high velocity, low amplitude thrust to the vertebra. Chiropractors use this technique to correct the body’s spinal alignment to relieve pain and improve function and to allow the body to heal itself. Treatment usually takes between 10 to 20 minutes and most patients are scheduled 2-3 times per week initially. Patients generally see improvement of their symptoms in the first two to three weeks (Harvard Health Publications).

Harvard Medical School is now saying what chiropractors have been saying for over 100 years and although their article was based on pain, it does add more evidence to the false rhetoric of chiropractic patients having a greater risk of stroke. In the future, reports from Harvard and other medical academic institutions will embrace the growing body of scientific evidence of the varied maladies that respond to chiropractic care.

 

References:

  1. Harvard Health Publications. (2015). Chiropractic Care for Pain Relief. Retrieved from http://www.health.harvard.edu/pain/chiropractic-care-for-pain-relief

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Published in Low Back Problems

More Research