Fibromyalgia (FM) HCPs
Fibromyalgia (FM) has a long reputation for being a controversial diagnosis. Some health care providers (HCPs) believe Fibromyalgia is a valid condition that warrants research and treatment while some feel it is a “garbage can diagnosis” which HCPs throw patients into when they are unsure what diagnostic tag to use to describe a patient’s condition. Irrespective of the personal beliefs of individual HCPs, there have been two general classifications of Fibromyalgia: primary and secondary. Primary FM takes place when there is not any underlying health condition engaging in the patient’s overall health status and the beginning of FM. Secondary FM results in an underlying condition that contributes significantly to the patient’s health condition, such as irritable bowel syndrome and with time, gives rise to the onset of Fibromyalgia.
Posttraumatic FM is owned by the secondary FM classification once the trauma-related injury leads to the individual developing FM. A Canadian study reported that 25-50 percent of Fibromyalgia patients reported a traumatic event before their FM symptoms started. This study surveyed different specialty physician groups to ascertain which issues were most important in causing the onset of widespread chronic pain following a motor vehicle injury. Five variables were studied to ascertain how important each was to the HCP in arriving at the Fibromyalgia diagnosis at a case study of a 45-year-old female with a whiplash injury who developed chronic generalized pain, fatigue, difficulties in sleeping, and diffuse muscle tenderness. These five variables included:
- The amount of FM cases diagnosed weekly by the HCP.
- The individual’s gender.
- The force of the initial effects.
- The patient’s psychiatric history prior to the injury.
- The first injury severity.
The researchers also considered the patient’s pre-injury health status, fitness level, and emotional health to be significant also. All HCP groups were reluctant to attribute the automobile accident as causing FM, but instead placed more importance on the individual attitude, personality, and degree of psychological stress. The least important of the five points were numbers 3 and 5. The orthopedic group also contained “ongoing litigation” as a cause but as a team, they were the least likely to agree about the Fibromyalgia diagnosis (29%) in this specific case study. Rheumatologists were the most likely to diagnose FM in 83%, followed by general practitioners at 71% and physiatrists in 60%. A most interesting observation was that after the data was examined, ONLY the patient’s pre-accident psychiatric background stayed in the model of calling agreement or disagreement with the FM diagnosis.
Posttraumatic Fibromyalgia may result from any sort of trauma, not only motor vehicle collisions. Additional “secondary” FM causes besides trauma may include systemic conditions like irritable bowel syndrome, chronic fatigue syndrome, and other internal ailments that in part, change the individual’s ability to get restorative sleep. Therefore, an important focus of treatment should be placed on helping the Fibromyalgia patient obtain restful sleep. Chiropractic management approaches have included manipulation, mobilization, soft tissue treatments, physiological therapeutic agents like electrical stimulation, ultrasound, and the training for home use of grip, using nutritional counseling and supplementation, and exercise training. Many studies support successes with this multidimensional approach to treating FM as chiropractic attacks the FM condition from several directions, often affording highly satisfying results.