A Gentle Approach to Chronic Pain

A Gen

Breaking the Chronic Pain Cycle of Fibromyalgia

                  Chronic pain takes many shapes and forms, but we know that it has a huge social and economic burden. The Institute of Medicine reports that roughly 116 million, or 30% of the population suffer from pain lasting a year or longer. Although chronic pain isn’t a life threatening issue, it’s certainly a problem that has a dramatic effect on the quality of someone’s life. After taking care of hundreds of people with conditions like fibromyalgia, I know that these people experience quite a toll both physically and emotionally.

NUCCA requires a specific angle to achieve a desired correction angle.

NUCCA requires a specific angle to achieve a desired correction angle.

                  Perhaps the worst part about fibromyalgia is that there is no known cause or cure. It’s basically invisible to any blood tests or MRI studies, and most of the drugs available are for pain control. People with fibromyalgia may often be depressed, have anxiety, and have a sense of isolation because they don’t feel that their friends and family understand their struggle. This often compounded by the fact that their doctors have told them that the pain is psychosomatic, or just in their minds because no tests can reveal an underlying disease process.

                  In recent years, fibromyalgia has become one of the most published topics in medical journals. As a result, we are starting to develop an understanding of the disease on a deeper level to know that it’s certainly NOT just in the patient’s mind. Research is pointing to problems within the central nervous system and tiny blood vessels in the skin as likely causes of the deep body-wide pain. But what does this mean in terms of treatment?

                  For most people, drugs that target the nervous system like Lyrica or Gabapentin are the first line of treatment and many have had success. However, some patients can be sensitive to drug reactions, or their bodies may develop a high tolerance for the dosages. In cases like these, many patients start to seek out alternative therapies like acupuncture, reiki, and homeopathy.

                  Traditional chiropractic has also been a source of relief for many people seeking help with chronic pain. However, many people with the chronic pain of fibromyalgia can feel apprehensive about seeing a Doctor of Chiropractic because manipulations can seem too rough for someone who can barely stand to be touched.

Not All Adjustments are Built the Same

                  In chiropractic, there are dozens of techniques and approaches to correcting the spine. Some are heavy handed and require a lot of force, but others are very gentle and rely more on precision. It’s not to say that one is better than the other, but some are just designed for specific patient populations in mind.

                  In my office, I attract many patients with fibromyalgia, trigeminal neuralgia, and TMJ problems that are Secondary to a Structrual problem in the neck called Atlas Displacement Complex. Most of these people are afraid to be touched, and gravitate to a lighter approach. This type of condition requires a precision type of adjustment called an Atlas Correction. This type of adjustment is so light, that most people often wonder if I even touched them, and then they start to feel their body change. Currently, only about 1000 doctors in the country are trained in this type of care.

                  This approach is effective because of the spine’s influence on the central nervous system. When the top of the neck shifts abnormally and moves improperly, the nerves firing into the brainstem become distorted. In this way, the brain is like a computer that relies on spinal positioning to operate normally. When there are garbage signals going into the brain, then garbage signals come out in the form of pain. This phenomenon in fibromyalgia patients creates a condition called central sensitization. This is the reason why people with fibromyalgia can feel excruciating pain from a light touch. It’s not that there’s a physical injury, but the nervous system is getting scrambled signals and is primed to experience pain.

Your nervous system can act like a computer. If poor information comes in, then poor information will come out.

Your nervous system can act like a computer. If poor information comes in, then poor information will come out.

                  This is NOT designed to cure you. The cure lies in the fact that the body is capable of healing itself. When you remove interference to the body’s self-healing ability, I find that people can return to a level where life is livable again. By breaking the pain cycle through the nervous system, you can impact the way stress affects the body and the immune system. By no means is this a cure all, but it can be a great catalyst to being steered back on the path towards a normal life. I’ve seen numerous patients who’ve been able to go from disability to working or resuming exercise again in a matter of months.

One of the greatest joys of doing this type of work is giving people a glimmer of hope. So many people are convinced that they have to live in pain, or have been told that the problem they’re having is all in their head. In my office, I’ve helped hundreds of people recover from chronic pain with this gentle procedure. However, it’s not for everyone. Only people with a problem in their Atlas can receive this type of care, and that requires a detailed Upper Cervical Chiropractic Examination to identify the problem. Sometimes a little bit of hope is all a person needs to start healing again.

Fibromyalgia and the Atlas

FIbromyalgia and the Atlas


Read time: [5 minutes]


Fibromyalgia Syndrome (FMS) and other conditions involving chronic pain are among the most frustrating conditions that affect a human being. While the condition is not life threatening, it is without a doubt life impairing.

While the pain of a surgical procedure, broken bone, or acute disc injury can be more excruciating, the pain from those tissue injuries will tend to decrease over time. Pain from FMS is unique in the fact that there is frequently no injury to treat and the pain seems to have no expiration date. That patients must learn to live with the expectation that it may never go away.

This can make you feel a sense of helplessness if you have been diagnosed with FMS. If you have fibromyalgia, it’s common for you to just feel run down, tired, and in agony but you don’t know why. This results in friends and family members feeling like you’re a hypochondriac, and often results in ostracizing the afflicted patient.

Fibromyalgia Syndrome and The Need for Integrative Care

Despite what many gurus, vitamin peddlers, and book sellers say, there is no cure for fibromyalgia. There are so many co-morbid illnesses tied with fibromyalgia that it has turned into a syndrome (FMS) as opposed to a single chronic pain entity. These symptoms include pain, brain fog, chronic fatigue, irritable bowel syndrome, and headaches. That is a wide variety of symptoms for one illness, and each have their own physiology behind it.

From that stand point, it wouldn’t make sense to try to have a one treatment fits all strategy to a condition like FMS.

Conventional treatment focuses on medications, progressive exercise, sleep disorder treatment, and psychotherapy to help control the pain of fibromyalgia. Exercise in particular has a strong track record for therapeutic benefit in FMS.

However, one of the things that I’ve seen after spending time hundreds of patients with fibromyalgia is that they find the mere thought of doing exercise to be overwhelming. Patients also find the idea of getting psychological therapy to be condescending to their condition despite the evidence that it is helpful.


All of this makes an evidence-based approach to fibromyalgia syndrome to be extremely challenging at this point in time. The end result is that new, experimental, alternative, and potentially pseudoscientific methodologies become entrusted to improve the quality of life in patients with this condition.

For decades, chiropractic and spinal manipulation has generally been lumped into this category. However, the growing amount of research is showing that manual procedures in the spine do have a real impact on the central nervous system. One study released last year tackled the fibromyalgia problem with some promising results.

The Addition of Upper Cervical Manipuluative therapy in the treatment of patients with Fibromyalgia: A Randomized Controlled Trial

Abstract Link

A clinical trial was published in the journal Rheumatology International. The authors looked at the addition of upper cervical spinal manipulation to a comprehensive fibromyalgia treatment regiment to see if it any effect on outcomes.

The standard treatment for fibromyalgia includes cognitive behavioral therapy, light exercise recommendations, and pain education. This study compared standard treatment alone and compared it to when standard treatment included manipulation of the upper neck. The patients were treated for about 12 weeks and had a follow up appointment in a year.

They measured changes in pain, sleep, anxiety, posture, and quality of life.


Interestingly enough, the group that received upper cervical manipulation didn’t have a significantly better outcome than the standard treatment group after 12 weeks. Both groups improved in their symptoms, but there wasn’t much difference between the 2 groups. On a good note, the postural measurements of the upper cervical group did improve quite a bit.

Here’s where the magic is:

At a one year follow up, the upper cervical manipulation group continued to show better control of their pain, sleep, anxiety, and posture even though they stopped getting manipulations. On the other side, the control group actually started to regress towards their original scores.


Important Notes

  • The study used a physical therapy technique called the Maitland Concepts. It’s not a chiropractic technique, but has elements of high velocity, low amplitude manipulation commonly found in chiropractic.
  • The patients continued to get better even after they stopped getting manipulation. A common knock against manual techniques is that you need to keep getting adjustments in order to feel better. The multi-modal approach used in this study suggests that patients can continue to get better even after treatment is done.
  • The authors showed that manipulating the neck created widespread changes in the patients’ posture measurements including the low back, shoulders, etc. They attribute this to the fact that the upper neck is a critical element to controlling the posture of the body.


You all know my biases as a chiropractor that uses a niche technique. The truth is, I don’t care about what techniques I end up using, or whether the technique was created by a chiropractor, physical therapist, or a marine biologist. All that matters is that people get great outcomes!

I love this study because it shows that changing the physical structure of the body can happen through the neck, and doing this can get people a great long term outcome from an illness that makes millions of people miserable.

Ask Dr. Chung a question