Fibromyalgia and Chiropractic

Dr. Paul Whitcomb, a chiropractor in South Lake Tahoe, Ca, doesn't want to offer fibromyalgia sufferers false hope. However, he has developed a chiropractic treatment that has been successful in treating 95 percent of his fibromyalgia patients. Approximately 3.7 million Americans, mostly women, currently have fibromyalgia, according to Dr. Whitcomb's website http://www.stopfibro.com.
"It turns out that fibromyalgia is an upper cervical spinal stenosis, which is actually a choking off of the spinal cord structures, but not so much the spinal cord as the meninges; the coverings of the spinal cord itself," explains Dr. Whitcomb.

Fibromyalgia appears most frequently in people who have suffered some sort of physical trauma, such as a car accident or a blow to the head. Some even recall abuse as a child, but Dr. Whitcomb, who himself suffered from fibromyalgia for three years, said he is currently researching and writing a book about another possible cause of the condition -- surgery.

"I think what's happening is, when you sleep at night you have muscle tone, and if you get sore or you're uncomfortable, you move out of that position -- when you're having surgery, you have no muscle tone at all. You're totally flaccid, and it doesn't take a lot to change something," Dr. Whitcomb said.

"I think what's happening -- I may be wrong -- but the position [surgeons] place the [patient's] head to put the trachea in is the same position [chiropractors] would use to take the first vertebrae and shove it forward." Dr. Whitcomb also theorizes the hospital staff tries different methods to support the neck and make the patient comfortable, but the supports they use often end up pushing the first vertebrae against the spinal cord. The adjustments Dr. Whitcomb makes in moving the first vertebrae from up against the meninges have meant relief for most of the patients who visit his clinic.

In an interview from the "Tahoe Daily Tribune," Dr. Adnan Sammour, an internist, said that one of his patients seems to have enjoyed great success with Dr. Whitcomb's treatment.

"She's almost completely pain-free, sleeping through the night and not requiring any pain medication," Sammour said. "She tried pain medicine, physical therapy, massage, acupuncture, and that did not help."

Some patients do not experience relief from their symptoms with Dr. Whitcomb's treatment. Dr. Whitcomb says they often are not suffering from fibromyalgia, and he also warns them of their limited chances of success beforehand. On his website, Dr. Whitcomb mentions two other hindrances to the success of his treatment. The first, overmedication, can be a problem, since patients often lose the ability to differentiate between the symptoms of fibromyalgia and the side effects of their medication. In addition, patients are often unwilling to discontinue use of their medications. The second hindrance can be the formation of scar tissue. Pseudo, or false, joints can develop after extended periods of living with fibromyalgia. Dr. Whitcomb, however, has had patients recover from their symptoms after 55 years of living with them.

Although fibromyalgia is defined as a chemical imbalance causing hypersensitivity in the nervous system that amplifies pain, the symptoms go far beyond just pain, according to Dr. Whitcomb, "[The misaligned vertebrae] pulls on the meninges, which is not that flexible, which attaches to all the nerve roots all the way down the spine," he said. Since the nerves from the spine have to pass through the meninges, the pulling causes all the nerves to fire at one time. "Now these poor people have symptoms of everything that comes from these nerves, and so you will hear them say they have pain, they have numbness, they have tingling, they have burning, they're cold, they itch; those are just all the proprioceptive fibers that go to the brain from the different areas," said Dr. Whitcomb.

Patients can also be subject to pituitary and thyroid problems. They often experience an almost constant adrenal rush, as the pressure on the meninges causes a reaction in their sympathetic nervous system. Sufferers are basically in a constant "fight or flight" response.

What does this mean for the patients? "They can't sleep," said Dr. Whitcomb. "Even if they do get sleep, or even if they take medication to sleep, they still wake up exhausted." Additionally, the constant activity in the sympathetic nervous system often shuts down the patient's intestines, causing diarrhea, constipation and irritable bowel syndrome.

Dr. Whitcomb has found this barrage of pain and discomfort is often accompanied by irrational and uncontrollable mood swings, which are understandable given the severity of the symptoms. Family members and loved ones, however, sometimes feel pushed away by this behavior, and some even leave. This intensifies the feelings of hopelessness, and can lead to depression, sometimes to the point where sufferers feel their only remaining option is suicide.

"I'm trying to do some research to find out how many fibromyalgia patients commit suicide, and the closest we have right now is 14 percent," said Dr. Whitcomb. "But I'm not sure that's an accurate figure. It sounds way too high." Dr. Whitcomb added the national average for suicides is two per 100,000 people. "At any rate, I know it's high because people are sick and they definitely don't want to live like that," adds Dr. Whitcomb.

Part of the healing process, according to Dr. Whitcomb, is meeting and talking with other people who are suffering from fibromyalgia. Patients pack into Dr. Whitcomb's office from all over the world and end up forming close friendships with each other, to the point where some patients show up together in carloads. "It's wonderful...they've got somebody to cry with or hold hands with and the other women grab them and start taking them shopping and going places. That part of it's a real good time."

Not surprisingly, with such a large number of victims, and such serious symptoms associated with fibromyalgia, Dr. Whitcomb's high rate of proclaimed success has met with some skepticism. Dr. Whitcomb says he often wakes up in the morning and can't believe it himself. In the "Tribune" article, National Fibromyalgia Association president Lynn Mantallana said the word "cure" made her nervous, since no cure for fibromyalgia is known at the current time. Mantallana doesn't immediately discount Dr. Whitcomb's claims, however; she herself has suffered fibromyalgia for two years, and just feels more research is needed.

Dr. Whitcomb agrees. He has enlisted the help of Dr. Gregory Plaugher, director of research at the Life Chiropractic College West, to document the cases of 30 of Dr. Whitcomb's patients. "The reason I'm working with [Dr. Plaugher] is that he's an outside source, he's not in our office," said Dr. Whitcomb. "He's going to document and print the results as they come out."

The skepticism, however, doesn't just stem from Dr. Whitcomb's claims about a disease that has only been recognized as a diagnosis within the last five years. Dr. Whitcomb feels other factors may contribute to some of the doubt he is facing, or has yet to face. Among those factors are professional jealousy, misunderstandings and general negativity.

In the case of skeptical medical professionals, Dr. Whitcomb feels that most of them are just trying to address the symptoms as best they can, but they don't define any one treatment as "right" or "wrong". "[Chiropractors] kind of look at a lot of the things [conventional medical professionals] do, and go, 'Why in the world would you do that to a person that has this?' and they look at us and go, 'We think this should be done this way,'" Dr. Whitcomb said. "The problem I have with some of their patients is that they go to doctors and the doctors look at them and say, 'You know what your problem is? You just need to pull your act together, get a life, go back to work and quit whining.'" This type of bedside manner can exacerbate the depression and hopelessness fibromyalgia patients already encounter.

Although Dr. Whitcomb doesn't blame individuals or their doctors, he also has a problem with some patients and their medication. Fortunately, as relief comes for patients, their dependency on painkillers, such as morphine, Oxycontin, and Vicodin, recedes. "Most of my patients are either off of all their meds, or 80 percent are off them within six weeks," Dr. Whitcomb said. "So they usually leave here without meds. He further adds, "Some of the people who have been long term on antidepressants or something, sometimes they'll have to take longer to get off the medications."

Dr. Whitcomb would prefer to be able to send his patients straight to a detoxification program from his office, but he said that it's important to note that he would never take patients off their medication. He prefers to let his patients discuss getting off medication with the doctor who prescribed it, saying, "I don't like to interfere with what other people are doing. The same way I don't let them interfere with my treatment."

As patients begin to recover with his treatments, Dr. Whitcomb feels that it is important for patients to begin some lifestyle changes. Ideally, he would like to work with a resort where patients could go for exercise and detoxification programs, and help with positive diet changes. The road to recovery is intense, with patients visiting Dr. Whitcomb's office up to three times a day over a period of one to two months. "We normally will see a patient three times a day -- Monday, Wednesday and Friday, twice on Tuesday, twice on Thursday and once on the weekend," says Dr. Whitcomb.

According to the information provided on http://stopfibro.com, the intensity of the treatments is necessary to combat fibromyalgia's propensity to return to its abnormal state. Cost for the treatment is $62.50 per visit, which is less than the national average for chiropractors. The cost, however, can quickly add up due to the frequency of visits. A four-week treatment usually costs about $3,500. The cost includes exam, consultation, report of findings, and X-rays. Patients usually find the results well worth the price.

"Somewhere around three weeks [into the treatment], they start sleeping, and it's like a miracle," Dr. Whitcomb said. Patients sometimes think something has gone wrong with the treatment, because they seem to want to sleep all the time, but Dr. Whitcomb says that is a positive change. "I say, 'Good.' That's a real big landmark for us, because that shows me that the sympathetic nervous system is going back to normal." The increased sleep is usually followed by patients' systems recovering from irritable bowel syndrome, as the pain begins to subside. However, Dr. Whitcomb has noticed a setback that sometimes accompanies recovery. Patients have a bit of fear of returning to their life as a healthy person and what their loved ones will expect from them now.

"I have a video here that I show; a talk I give...I tell them, "Look, I want your spouse and everybody to know that you need to go home and you need some months to readjust to being a human being.' It's not easy, and a lot of people require counseling." Dr. Whitcomb employs a counselor for just that purpose, who works with his patients twice a week. Dr. Whitcomb also recommends following up his treatment with deep tissue massages.