Fibromyalgia is a difficult disorder for patients to fully recover from. Most patients will try a variety of alternative treatments, including chiropractic care. One study (Wahner-Roedler, et. al. Mayo Clinic Proc 2005;80:55-60) showed that 37% had used chiropractic care.
Because spinal joint pain is such a common co-morbidity in fibromyalgia, it seems reasonable to try chiropractic care, since it is one of the most studied treatments for low back pain and carries minimal risk for adverse reactions. Although the evidence for efficacy for manipulation is only modest, many patients may want to reduce their need for prescription/OTC medications, so patient preference is also a consideration.
As far as specific trials evidence for manipulation in fibromyalgia, the literature is scant. One pilot study (Blunt KL, et. al. J Manipulative Physiol Ther 1997; 20:389) showed that chiropractic management improved pain levels, increased cervical and lumbar ranges of motion, and improved straight-leg raising capability. Also a preliminary randomized cross-over trial (Citak-Karakaya I, et. al. J Manipulative Physiol Ther 2006;29:524) showed that connective tissue manipulation and ultrasound, improved pain intensity, complaints of non-restorative sleep, and impact on functional activities in patients with fibromyalgia.
If you refer a patient with fibromyalgia to my office, I rule out certain fractures or comorbidities such as joint laxity e.g. (SLE). You may inquire about the techniques of spinal examination and the thrust procedures I use. I do not find these questions prying and want you to feel comfortable when referring your patient.
Patients generally respond quickly, so there should not be months of treatment before deciding if chiropractic care is helpful. Ten to twelve treatments in a month often show improvement in frequency and intensity of pain. If your patient positively responds, then this is a rationale to continue with treatment. Chiropractic care is not a substitute for exercise, so the patient should also be increasing their activity levels during this time. I generally include weight-loss counseling, and home exercise approaches to overall care to enhance the clinical response. The addition of chiropractic care may make a patient prone to joint pain under exercise loading, to continue their active regimen. The adjustive interventions should gradually decrease in frequency as the patient responds to care.