Summary

Chiropractic treatment is being used to complement traditional medicine to treat fibromyalgia (FM).

A recent study examined chiropractic treatments that combined ischemic compression and spinal manipulation. The big question: Do these treatments effectively reduce pain, sleep disturbances, and fatigue associated with FM?

Twenty-four subjects participated – all were adult members of a regional Fibromyalgia Association who had suffered from FM for more than 3 months. Each subject received 30 different treatments combining ischemic compression and spinal manipulation. After treatment, subjects were evaluated for pain, fatigue levels, and sleep quality.

After just 15 treatments, subjects noted significantly less pain and fatigue and improved sleep. After 30 treatments, subjects noted average lessening in pain and improvements in fatigue levels and quality of sleep. These improvements remained constant one month after the study ended.

Results suggest that older subjects with severe, chronic pain and a greater number of tender points do not respond as positively to chiropractic treatment; however, chiropractic care should be examined as a possible beneficial treatment for others suffering from FM.

Abstract

Hains G, Hains F. Private practice of chiropractic, Trois-Rivieres, Quebec, Canada.

OBJECTIVES: To provide preliminary information on whether a regimen of 30 chiropractic treatments that combines ischemic compression and spinal manipulation effectively reduces the intensity of pain, sleep disturbance, and fatigue associated with fibromyalgia. In addition, to study the dose-response relation and identify the baseline characteristics that may serve as predictors of outcome.

DESIGN: Subjects were assessed with self-administered questionnaires taken at baseline, after 15 and 30 treatments, and 1 month after the end of the treatment trial.

METHODS: Participating subjects were adult members of a regional Fibromyalgia Association. Participating subjects had fibromyalgia for more than 3 months. They received 30 treatments including ischemic compression and spinal manipulation. The 3 outcomes being evaluated were pain intensity, fatigue level, and sleep quality. A minimum 50 improvement in pain intensity from baseline to the end of the treatment trial was needed to include the patient in the respondent category.

RESULTS: Fifteen women (mean age 51.1 years) completed the trial. A total of 9 (60) patients were classified as respondents. A statistically significant lessening of pain intensity and corresponding improvement in quality of sleep and fatigue level were observed after 15 and 30 treatments. After 30 treatments, the respondents showed an average lessening of 77.2 (standard deviation = 12.3) in pain intensity and an improvement of 63.5 (standard deviation = 31.6) in sleep quality and 74.8 (standard deviation = 23.1) in fatigue level. The improvement in the 3 outcome measures was maintained after 1 month without treatment. Subjects with less than 35 improvement after 15 treatments did not show a satisfactory response after 30 treatments. A trend, determined as not statistically significant, suggests that older subjects with severe and more chronic pain and a greater number of tender points respond more poorly to treatment.

CONCLUSION: This study suggests a potential role for chiropractic care in the management of fibromyalgia. A randomized clinical trial should be conducted to test this hypothesis.