A Functional Medicine Approach To Fibromyalgia in Boca Raton

neckpainWe have all felt tired and burned out in the past and thought nothing of it. Can you imagine feeling that way all the time? The degree of fatigue, inability to concentrate, fear of driving a car, confusion, depression, anxiety, and sleep deprivation can be overwhelming.

Frequently, health care providers seem to have little or no compassion for those coming to them with these symptoms. Unfortunately, Fibromyalgia patients are considered difficult patients by many physicians. It may be that they feel helpless, as most treatment approaches utilizing pharmaceuticals either dont work or may create side effects can be worse than the condition.

Fibromyalgia (FM) affects at least 6 million Americans; minimally 4 million of which are women (1). FM is the third most prevalent rheumatologic disorder (after osteoarthritis and rheumatoid arthritis) and it represents 5% of family practice office visits and 20% of rheumatology visits.

Approximately 90% of FM patients are women between the ages of 40 and 60 years, with an average age of 49. Some physicians feel FM does not exist and offer no therapeutic options while others over diagnose the condition using Fibromyalgia as a wastebasket diagnosis. (2, 3).

FM is a condition characterized by pain in the muscle and soft tissue fibers of the body. People with Fibromyalgia will experience widespread pain of at least three months duration. Some people are often unable to continue with their vocations due to this widespread pain. Other symptoms associated with FM include chronic fatigue (physical or mental), tiring easily, morning stiffness, urinary urgency, anxiety or stress, irritable bowel syndrome (IBS), sleep disturbance, tingling and numbness, excessive menstrual bleeding, gastrointestinal symptoms (2).

Some characteristic symptoms of Fibromyalgia and associated prevalence (pain symptoms) include widespread pain (98%), pain in the neck (85%), low back (79%), mid back (72%), 15 or more painful sites (56%), headaches (53%), and difficulty with menstruation (41%) (2).

If you experience tenderness in any number of these locations, it may indicate you suffer from Fibromyalgia. At Boca Health Care Center, Dr. Rosen can recognize and detect these tender points in a persons body and offer a multifaceted healthcare treatment plan including exercise therapy, stress reduction, nutrition and manual therapies that has shown the most promise for Fibromyalgia sufferers (5).

Other treatments that include drugs such as naproxen, ibuprofen, acetaminophen, etc., and muscle relaxants such as cyclobenzaprine, are often not sufficient to relieve the aching and discomfort. Unfortunately, drugs only mask the symptoms and carry significant side effects (2, 6). In a study reported in the American Journal of Physical Medicine Rehabilitation, Chiropractic care scored amongst the most effective measures, more effective than drugs (7).

Chiropractors recognize the importance of good spinal posture in affecting a variety of health problems, including fibromyalgia. It’s important to not think of the disease as having a single solution, but rather as a more complex entity, needing a comprehensive approach. Dr. Rosens care addresses spinal dysfunction, faulty posture as well as lifestyle issues such as stress, diet and exercise when managing the complex issues associated with fibromyalgia.

Having am exercise physiology background, Dr. Rosen believes that most patients with FM will benefit from increasing their activity level, gradually working towards a rigorous exercise program. Vigorous exercise increases endorphin levels, which block pain and elevates mood. The exercise approach should include both strength enhancement, such as circuit training with weights, and increasing aerobic activities, such as fast-paced walking. These have been shown in studies to help patients with both stress reduction as well as reducing the chronic fatigue associated with FM. Overall, pain levels are reduced by the addition of exercise though this may seem hard to believe since people with FM already have muscle pain. Exercise is also important in maintaining a healthy weight and improving self-confidence. If post-exercise soreness occurs after exercising, chiropractic approaches can be very beneficial.

Also Using the Spinal Decompression DRX 9000C table can be very helpful for the Fibromyalgia patient.

Recent research (Holman AJ. Positional cervical spinal cord compression and fibromyalgia: a novel comorbidity with important diagnostic and treatment implications. J Pain 2008; May 20 epub.) has looked into a specific problem seen in fibromyalgia patients: spinal cord compression. In the study, 71% of patients with fibromyalgia had positional cervical spinal cord compression.

So what does this mean? It means if you have fibromyalgia there may be an undetected cervical compression problem that may also be affecting you.

Good neck posture and mobility are keys to good health. We can diagnose your condition and see if there is a spinal component to your problem that may have been overlooked. Sometimes it’s the low back pain that keeps us from exercising and ultimately getting rid of the fibromyalgia-inactivity-pain cycle. And, as the research above suggests, maybe the problem is in the neck and this needs to be addressed in a specific and comprehensive manner. Sometimes immobility in one area of the spine is compensated for in another, which can make your ability to heal somewhat lessened. Maybe the neck has been a concern of yours for a long time since the fibromyalgia symptoms came on following a neck trauma such as a whiplash. If you also suffer from headaches and have spinal pain, these are important clues that some of your symptoms may be spinally related. Spinal Decompression will help in these cases.

It’s important to view your fibromyalgia symptoms from a global perspective, and not just think of one isolated issue as the root cause, and the only place where treatment needs to be directed. At Boca Health Care Center, Dr. Rosen makes it part of his examination to evaluate the fibromyalgia patient from this global perspective.

Diet is also important since food is the fuel our bodies run on. If you put diesel fuel into your regular gas engine car, the results will not be good! The engine will kick and sputter and eventually die after gumming up the fuel lines. This is analogous to eating too many refined carbs (simple sugars), eating transfats, eating too excessively and/or eating too quickly.

We treat patients with FM using a variety of methods. Since every patient is unique, various approaches and techniques may be employed. These may include chiropractic spinal and extremity adjustments, spinal decompression using the DRX 9000 Cervical and/or Lumbar machines, physical therapy modalities such as electrical stimulation, light therapy and/or others, as well as advice on diet and nutrition, supervising exercises, and discussing work station modifications, may be employed. If you or a loved one is suffering with FM, sharing this information may be one of most significant acts of kindness you can give to those that you care about.

If the side effects of medication outweigh the benefits, or if youre looking for a non-drug approach to FM, the combination of nutrition, exercise, and chiropractic care should strongly be considered. This approach is specifically utilized at our clinic.

1. Soderberg, S., Norberg, A., Metaphorical Pain Language Among Fibromyalgia Patients, Scan J. Caring Sci., 1995, 9: 55-59.
2. Wolfe, F., Diagnosis of Fibromyalgia, J. Musculoskeletal Med 1990: 7(7): pp. 53-69.
3. Bennett, R.M., Myofacial Pain Syndromes and Fibromyalgia Syndrome: A Comparative Analysis. Man Med 1991; 6(1): pp. 34-45.
4. Duarte, M., Primary Fibromyalgia Syndrome and Myofacial Pain Syndrome: Clinical Features and Criteria for Diagnosis. Chiro Tech 1989; 1(3): pp. 97-100.
5. Cox, James, M., Low Back Pain: Mechanism, Diagnosis and Treatment, Chapter 7, pg. 251
6. Campbell, S.M., Gatter, R.A., Clark, S., et al. A Double-Blind Study of Cyclobenzaprine versus Placebo in Patients with Fibrositis, Arthritis Rheumatology 1986; 29: pg. 1371.
7. Waylouis, W.G., Heck, W., Fibromyalgia Syndrome: New Associations, Am Journal Phys Med Rehabilitation, 1992; 71: pp. 343-348.

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