Fibromyalgia is present in 2-8% of the population, so it is an important condition to be able to treat conservatively as future chiropractors. Fibromyalgia is classically accompanied by fatigue, memory problems, and sleep disturbances. Fibromyalgia causes chronic widespread pain, and is an underdiagnosed condition. It is best managed as a chronic disease in which the primary care physician and other associated providers provide comprehensive care and continuous management of symptoms.
Risk factors associated with the development of fibromyalgia include genetic factors, female sex, and the presence of other painful conditions. Other painful conditions, such as rheumatoid arthritis and systemic lupus erythematosus are strongly associated with fibromyalgia, potentially due to the secondary central sensitization. Modifiable risk factors that may predispose individuals to the condition include sleep disturbances, physical inactivity, and obesity.
The clinical features of fibromyalgia are that the patient has chronic pain (>3 months) that is generalized and occurs in multiple sites, and that the pain is associated with fatigue, sleep problems, or cognitive/somatic symptoms. The individual may present with the chief complaint of “I hurt all over,” which is a classic statement from an individual with fibromyalgia. Additionally, some patients report cognitive problems affecting their memory, attention, and ability to focus or concentrate, commonly referred to as “fibro fog.”
The overall approach to treating fibromyalgia should include maintaining function, improving quality of life, and the maintenance of symptoms. It is important to diagnose coexisting conditions, such as sleep disorders and major depressive disorder. Engagement in regular physical activity is crucial in the effective management of fibromyalgia. It is also crucial to educate the patient on the importance of sleep in moderating pain, fatigue, and cognitive symptoms. The utilization of acupuncture may provide benefits in terms of fatigue, pain, and well-being. Evidence is limited on the effectiveness of chiropractic manipulation, and more research is necessary. As fibromyalgia is incurable and chronic, conservative management is necessary for these patients to have the best quality of life.