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Instrument-Assisted Spinal Manipulation, Soft Tissue Mobilization, and Dietary Supplements for the Management of Pain in a Woman With Fibromyalgia: A Case Report

McRoberts AJ, Martin BR

Journal of chiropractic medicine, 2025

Abstract

Objective: The purpose of this case report is to describe a multimodal treatment approach for a middle-aged woman with fibromyalgia (FM).

Clinical features: A 52-year-old woman presented with FM. She did not respond to pharmaceutical interventions. Her condition manifested as focal, bilateral pain in her hands, wrists, lumbar spine, thoracic spine, and cervical spine. She experienced pain 75% to 100% of her day, which was exacerbated by carrying or lifting, changing positions, household chores, lying down, raising her arms above her shoulders, and stress. Due to the severity of her condition, she had poor grip strength and transient tremors in her hands. The pain interfered with her sleep every night.

Intervention and outcome: The treatment strategy involved a multimodal approach using instrument-assisted spinal manipulation to the lumbar, thoracic, and cervical spine, hands and wrists soft tissue massage, and supplementation with omega-3 fatty acids, N-acetylcysteine, l-theanine, and valerian once per day. After treatment, her pain was manageable. She reported improvements in her range of motion in her hands, wrists, and lumbar, thoracic, and cervical spine, and improvements in her hand tremors, grip strength, and sleep quality.

Conclusion: A female with FM had improvements in her symptoms and quality of life following a multimodal conservative treatment regimen.

How strong is the evidence?

Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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