Question
I have had RA and fibromyalgia for the last twenty years.  The pain level has been out of control for the last ten months which the doctors have had limited success in controlling.  How can chiropractic services help me with the pain level?  Are insurance companies relucant to pay for the services?  I need to start an exercise program and I can barely walk.  Sorry for all of the questions but I am at a hard spot.

Answer
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Hello D.,

You asked a really great question.  Regarding both fibromyalgia and RA, yes, chiropractic can help.  However, the problem with both chiropractic and these conditions is that they can all have dramatic variations.  For example, chiropractic has over a hundred techniques and is still considered by some to be "complimentary and alternative medicine," though highly debated.  Because of this, chiropractors can vary from one to the next.  You may go to 3 different chiropractors who all practice the same way with the same technique that do not seem to help you much.  Then you may go to a fourth chiropractor who practices completely different and who dramatically helps your pain.  It just varies, so you have to be very patient.  There are chiropractors that use a little more force and there are chiropractors who use very little force.  I would think that because of the nature of your condition, you might respond better with gentler techniques.  The chiropractor may also want x-rays to evaluate for ligamentous laxity because RA has a tendency to attack an important ligament in the upper neck, and this being the case, adjustments are often contraindicated (not advisable).  A knowledgeable chiropractor will evaluate for this and/or avoid neck adjustments altogether.  For fibromyalgia, gentler soft tissue techniques of chiropractic tend to be helpful, including massage or trigger point therapy.  If you try several chiropractors with little improvement in your conditions, I would definitely recommend supplementing your chiropractic care with acupuncture.  Some clinics will even offer chiropractic/acupuncture packages at discounted rates.

With regards to your insurance, yes, many insurance policies cover chiropractic.  Some insurance policies can pay quite well.  Because of the nature of your conditions, and perhaps with letters from doctors and lab reports documenting the RA and fibromyalgia, you may even be able to get extended chiropractic coverage through your insurance.  However, insurance is a case-by-case scenario, and there are just as many insurance policies that do not cover chiropractic care.  It just depends.  Your chiropractor can check for you.  Be aware, though, that not all chiropractors take insurance, so you may need to call around.

Fibromyalgia is a tricky condition that can leave many allopathic doctors scratching their heads.  It used to be classified as a psychiatric disorder.  From my experience and knowledge, fibromyalgia (and RA to a degree as well) will respond most positively with a proper nutritional assessment.  I would strongly urge you to go see either a certified nutritionist or a naturopathic doctor, preferrably the naturopathic doctor (N.D.)  Naturopathic doctors are just now starting to receive licensure in all of the states, but the education of the ones that I have worked with has been impeccable.  For people with your types of conditions, especially that respond poorly to traditional care, I immediately refer to an N.D.  Unfortunately, because their licensure is a work in progress, there are not too many of them around, so one may not be located near you.  To learn more about naturopathy and to find an N.D. near you, check out this website: http://www.naturopathic.org/
If you cannot find an N.D. near you, try to look for a chiropractor who specializes in nutrition.  You can look for a chiropractic nutritionist here: http://www.councilonnutrition.com/member_search/index.php
If you could find acupuncture, chiropractic, and nutritional counseling all under one roof, then I'm confident you'll start to see  improvements in a few months.

Most importantly, if the doctor you see does not seem to be helping the condition, keep looking around for the same type of doctor.  I believe you can improve with therapies mentioned above, but the toughest part may just be finding a doctor that you work well with.

Best of luck!
Dr. J.R. Strecker, D.C.