Fibromyalgia is a chronic (long-lasting) condition that can be very disabling. It’s characterized by extreme fatigue and widespread body ache that affects the body’s soft tissue–the muscles, ligaments, and tendons. Tender points most commonly occur in the back, neck, shoulders, lower back, hands, hips, and knees. Fibromyalgia symptoms and related disabilities, which may vary in intensity and duration, may include headache, skin problems, depression, anxiety, sleep disturbances, numbness or tingling in the hands or feet, or impaired vision. Fibromyalgia pain, which is often worse in the morning or evening, is sometimes described as throbbing, twitching, stabbing, or shooting and may intensify in cold or damp weather, or with fatigue, inactivity or too much activity, stress, or anxiety. Symptoms may wax and wane. The impact that Fibromyalgia disabilities has on daily living, including the ability to work a full-time job, differs among patients. Studies show that Fibromyalgia may be equally as disabling as rheumatoid arthritis. Although the cause of Fibromyalgia is unknown, and people of all ages and races are affected, the illness tends to strike women more often than men.


Fibromyalgia is thought to be caused by trauma to the upper cervical region of the spine.

This trauma could cause compression of the brainstem, causing Substance P to be released throughout the body. Substance P is a brain chemical, or neurotransmitter, that works as a pain messenger. Abnormally high levels of this chemical may account for the chronic pain in patients with fibromyalgia. By correcting any misalignment of the upper cervical spine, many fibromyalgia sufferers get relief from the disability through BLAIR UPPER CERVICAL TREATMENT.


American Fibromyalgia Syndrome Association, Inc Web site. Available at: Accessed February 22, 2005.

Hammerly M. Fibromyalgia: The New Integrative Approach. Holbrook, Mass: Adams Media Corp., 2000.

Mense S, Simons DG, Russell IJ. Muscle Pain: Understanding its Nature, Diagnosis, and Treatment. Philadelphia : Lippincott Williams & Wilkins, 2001.

Patarca-Montero R. The Concise Encyclopedia of Fibromyalgia and Myofascial Pain. New York , NY : Haworth Medical Press, 2002.


  • American Fibromyalgia Syndrome Association, Inc.
  • Nonprofit organization dedicated to research, education, and patient advocacy for fibromyalgia syndrome and chronic fatigue syndrome.
  • National Fibromyalgia Association
  • Nonprofit organization dedicated to developing and executing programs that improve the quality of life for people with fibromyalgia by increasing awareness of the public, the media, the government, and the medical community .
  • Fibromyalgia Network
  • Produces subscription newsletter and provides updates, events, and information for patients with fibromyalgia.


Statistics show that fibromyalgia is one of the most common musculoskeletal pain and fatigue disorder in America, affecting up to 10% of the population.

Fibromyalgia and the Brain Stem

The brain stem, which can be compared to a telephone cable with thousands of individual wires or nerve fibers sending signals between the brain and the body, controls nearly all vital functions. Misalignments in the upper cervical spine (neck) can affect the function of the brain stem, which can be a critical factor in the development of fibromyalgia and chronic fatigue syndrome.

Trauma or compression of the upper neck can cause the same symptoms seen in fibromyalgia or patients with CFS. These symptoms may appear immediately after the injury or several years later.

Most FM patients suffer with chronic pain, stiffness and burning in the neck, shoulders, lower back and hips. Others experience depression, chronic fatigue, irritable bowel syndrome, numbness, dizziness, headaches or sleeping disorders. Even minor exertion can aggravate the pain and increase fatigue.

Fibromyalgia & Neck Injuries

Although the exact cause of fibromyalgia is not fully understood, numerous studies and clinical trials show that FM often develops after traumatic neck injuries. Nearly 70% of the fibromyalgia patients at Upper Cervical Health Centers of America could relate the start of their fibromyalgia symptoms to a specific injury to their neck. Car accidents, sports or on-the-job injuries, repetitive stress, falls, or even birth trauma can cause these injuries. Renowned neurosurgeon Dr. Michael Rosner, states that when the neck is hyper extended backward, the spinal canal narrows, impacting the spine and brain stem. This can occur in cases of whiplash in automobile accidents, extended dental work in which the head is bent back, or severe bouts of coughing. Even activities like painting a ceiling can cause injury to the neck that may lead to fibromyalgia.

Fibromyalgia / Chronic Fatigue Syndrome


Fibromyalgia pain is described as deep aching, radiating, gnawing, shooting or burning. The overwhelming characteristic of fibromyalgia is long-standing pain at defined tender points (myofascial trigger points).The initial patient profile of fibromyalgia syndrome includes a history of widespread pain of at least three months’ duration, both above and below the waist and including both sides of the body.

Ninety percent of fibromyalgia sufferers also are afflicted with chronic fatigue syndrome. In addition to pain and fatigue, common symptoms include malaise, headaches, numbness and tingling, dizziness, sleep disturbance, swollen feeling in tissues, stiffness, sensitivity to noise and stress, and cognitive impairment.

How Upper Cervical Care Relates to Fibromyalgia / Chronic Fatigue Syndrome

While the exact cause of fibromyalgia syndrome is unknown, recent research has pinpointed traumatic neck injury (whiplash, concussion, etc.) as a risk factor for fibromyalgia and chronic fatigue onset.1-14 Following the cervical spine injury, pain and fatigue symptoms can be triggered immediately or can take months or years to develop. The purpose of upper cervical chiropractic care is to reverse the trauma-induced upper neck injury; thereby reducing irritation to the nerves in the brainstem and spinal cord that can trigger pain, neuromuscular dysfunction, and fatigue.

While many fibromyalgia sufferers recall specific traumas such as head injuries, auto accidents or falls, some do not. An evaluation is necessary in each individual’s case to assess whether an upper cervical injury is present and whether benefit from upper cervical care can be achieved.

Patient Testimonials


Case Studies – Fibromyalgia / Chronic Fatigue Syndrome

Male, Age 11 years, Fibromyalgia, Fatigue, ADHD, Headaches, Sleep Disorder

This 11-year-old male suffered with Fibromyalgia, Chronic Fatigue, Attention Deficit Hyperactivity Disorder, and Headaches for many years. He experienced constant muscular pain throughout his body and had trouble participating in sports or exercise due to pain and muscle spasms. He couldn’t even wear a watch due to pain around his wrists. He frequently took hot baths or used a heating pad to relax his muscles. In addition, he was home-schooled due to frustration and difficulty in school. Headaches occurred twice per week, sometimes severe. His sleep was extremely irregular– he usually awakened every few hours. Frequently he would be in bed for 13 hours and still wake up fatigued.

During this 11-year-old’s upper cervical chiropractic exam, an upper neck injury was found. When questioning his mother about the boy’s medical history, she recalled that he fell out of a grocery cart at age 3 months. After only 1 month of upper cervical care, all symptoms were greatly improved. He was able to participate in sports without pain; he no longer had muscle spasms; all headaches were gone; school work improved in that he had less frustration and better attention span; he slept through the night and had energy upon awakening; and all fatigue was gone.

Female, Age 8 years, Sensory Integration Disorder, Fatigue, Trouble Sleeping, Headaches

This 8-year-old female was diagnosed with sensory integration disorder at age 7. Her mother described her sensitivity to noises (especially outside noise) and lights since birth. Her mother also remarked her slowness to develop normal muscle tone as an infant. She had been undergoing occupational therapy for the past year prior to seeking help from upper cervical care. This child also suffered from headaches and severe fatigue. The fatigue was attributed to her inability to sleep. Almost every night, she awakened in the middle of the night and went to her parents’ room (which was also exhausting for her parents). This child’s health history also included chronic ear infections (8 per year for her first 3 years of life, which were eventually lessened through homeopathic treatment). Because of the sensory integration issues and fatigue, this child had difficulty making friends or participating in social situations and preferred to be home alone in her room. Her mother described her as “being unhappy” most of the time.

During this child’s initial upper cervical evaluation, an upper neck injury was found. When questioned as to past traumatic events, her mother described the birth itself as seemingly normal, except it occurred 5 weeks premature. She also remembers that her daughter fell off of a counter at 6 month’s old and had several falls while learning to walk.

Within the first month of upper cervical care, this child began to sleep through the night without awakening. Her mother reported a gradual improvement in her energy level and mood. By the second month, all headaches were absent and her mother stated that her daughter’s behavior was improving, along with her energy and mood. Six months later, her mother reported that her daughter was consistently happy and energetic, which was the first time in 8 years. One year later, during a reexamination by her occupational therapist, her therapist no longer found evidence of sensory integration issues and released her from occupational therapy.

Female, Age 47 years, Sleep Disorder, Fatigue, Depression

This 47-year-old female suffered from a sleep disorder since her daughter’s birth 12 years prior. She had been unable to get a good night’s sleep since and as a result was extremely fatigued. She also described trouble with depression and mood swings because of her extreme lack of sleep. She described most nights with frequent awakening without any consistent sleep hours in a row.

During her initial evaluation, an upper neck injury was discovered. It was postulated that going through the birthing process was enough to cause injury in her case since the development of the sleep disorder coincided with her daughter’s birth. One week after the initiation of upper cervical care, she began sleeping and reported several nights where she slept between 7 and 10 hours without awakening. This continued consistently and she felt her energy and her happy mood return. Eventually she was able to discontinue all sleep and anti-depression medications.

Female, Age 60 years, Fibromyalgia and Chronic Fatigue Syndrome

“Somehow, somewhere far from home, I got my life back. After 27 years of gradually-progressing fibromyalgia, the pain and all-encompassing fatigue is gone. It is miraculous!

In July of this year I was sure I had no life, no energy to imagine getting though another day. When my pain reached a scale of 8-10 most of the time and I had to use a wheelchair to get around because my feet hurt after walking the length of my house, my doctors tried some new medications. This bought me enough time to travel to Maui for a vacation; I figured that at least I would hurt in a beautiful place with lots of green plants, warm water and sunshine. Instead, accidentally, I found a chiropractor who in a matter of weeks would give me back my life. I was reading a newspaper and found an ad for Dr. Erin Elster DC, specializing in upper cervical chiropractic care. Because a neck adjustment had sometimes brought temporary relief, I made an appointment.

While sitting in her office I picked up a paper and read an article that touted a 90% cure for trauma-based fibromyalgia. Trauma-based; yes, my four neck traumas fit that criteria. She sent me for x-rays, something I had endured before with no answers. When I returned, she pulled up the x-rays and showed me something I could not have imagined. My neck had been pushed ever so slightly out of alignment with the axis of my head. The consequence of “ever so slightly” was constant and unrelenting pain and she told me she could fix it. I cried, of course, and had my first adjustment. She had me on my knees bent over a stool and took the heel of her hand and gently moved my atlas into the correct placement. She, then, had me lie down in a quiet room for 30 minutes to recover. By the time I stood up, I was able to stand straight for the first time in years. My legs no longer tingled and zapped. My head no longer felt like it weighed 50 pounds. My feet did not hurt from the weight of my body. And I cried again.

I returned to her office every 3-4 days during my vacation. All but one of the visits she did another adjustment, using a temperature-based tool to see of it had slipped back. It has been in the incorrect posture for so long it could take many adjustments to retrain the muscles and tendons. But it worked and my pain is gone. Not just a bit better, but gone. I actually have walked and hiked around the island several times.

I had often thought my pain was rooted in my neck. I tried almost every chiropractor in town; if they were able to even adjust my neck, the relief was temporary and within days the pain returned. An MRI showed mild degeneration and osteoarthritis. Dr. Erin Elster actually showed me the slip on several x-ray views of my neck within one day. She then fixed it. It was all she does actually, and very successfully.

Will I always feel this way? In less than a week I return to my home and will see what joys await. I found a provider of upper cervical care 60 miles from my home to follow up with. I do not want to miss these next couple of decades for anything. I will never forget Dr. Elster – she saved my life!

Female, Age 38 years, Chronic Fatigue Syndrome

This 38-year-old female was diagnosed with chronic fatigue syndrome, following two different accidents: an auto accident and a scuba diving accident in which she suffered decompression sickness. She described her symptoms as including extreme fatigue, sleeplessness, “brain fog”, disorientation, dizziness, ringing in ears, stiff neck & joints, and visual disturbances. These symptoms had been present for the past 2 years prior to seeking help from upper cervical care and had worsened considerably to the point of being debilitating in the last four months. She had been out of work for some time since the symptoms began because of their severity and thought she would have to move home and live with her parents because she could no longer support nor take care of herself. Her neurologist had performed an MRI and a spinal tap, which both came back negative.

During her initial upper cervical evaluation, an upper neck injury was discovered, which likely stemmed from the auto accident and/or scuba accident. During the first six months of upper cervical care, her symptoms gradually lessened to the point that she began to sleep better, felt better energy, experienced less “brain fog”, and felt well enough to go back to work. By the end of a year, all symptoms were absent.

Female, Age 20 years, TMJ, Fibromyalgia

This 20-year-old female suffered from several health problems following an accident in which she was hit by a wave while swimming in the ocean. The wave caught her off guard and knocked her to the ground. She described how her face and jaw hit the ground first, and then her legs rolled up and over her head from the force of the water, severely “pinching” her neck. Immediately following the impact, her jaw “locked up” and emergency room physicians “forced open” her jaw in order to take x-rays of her neck. No fractures were found.

Subsequent to the accident, she developed chronic problems with her jaw. Her jaw frequently “locked up” and while she wore a mouth splint regularly, the jaw problems continued. In addition, she suffered with pain and muscle spasms throughout her spine and was diagnosed with fibromyalgia. She described all of her muscles as being painful and weak.

After no success with multiple different therapies and treatments, she sought help from upper cervical chiropractic care. During her evaluation, a spinal injury stemming from her upper neck was found. During her upper cervical care period, her symptoms gradually lessened. She was able to go without wearing the jaw splint and was able to close her mouth completely and open and shut it without having it lock up on her. In addition, all of her pain decreased dramatically and she was able to get back to a regular exercise, work, and school schedule.

Female, Age 47 years, Fibromyalgia, Whiplash

This 47-year-old female suffered from fibromyalgia for four years prior to seeking help from upper cervical care. Her symptoms began one month following an auto accident in which her head whipped back and forth (whiplash). She felt the pain most often in her back, neck, shoulders, chest, and hands. The pain in her chest became so strong at times that it hurt to breathe.

During her initial exam, myofascial trigger points were palpable throughout her back, neck, chest, and legs. Her hands were so painful that she had difficulty opening them or making fists. She rated the pain as an 8 or 9 on a scale of 1-10 with 10 being the most severe. She tried many drugs including amitriptyline to reduce the pain enough to help her sleep at night. Her upper cervical exam revealed an upper neck injury, which most likely occurred during her auto accident. After 6 months of upper cervical care, she routinely reported the pain being down at a tolerable “3” level– a level which no longer ruled her life. She was able to discontinue medications. She had not had pain during breathing and participated more actively in life with minimal discomfort.

Female, Age 19 years, Headaches, Insomnia, Fatigue, Fainting Spells

At age 15, this 19-year-old female was struck by several large waves while on vacation with her family. After the waves hit her and knocked her face-down against the ocean floor, she ran out of the water with severe pain in her neck and back. While she appeared to recover, when she returned home at the end of the vacation, she began having fainting spells, where she would wake up in strange locations, not knowing what had happened. One fainting spell occurred while she was driving her car, causing her to run a red light and get hit by a bus traveling the opposite direction. After this incident, she was no longer allowed to drive. In addition to the fainting spells, she also began suffering from headaches, which escalated into a constant, daily occurrence, as well as frequent insomnia, which lead to extreme fatigue.

After consulting with several local doctors and undergoing numerous tests, including an MRI, her physicians could not find anything wrong with her and could only conclude that she had migraines and possibly psychological problems. Not accepting this, this patient and her parents searched the internet for additional help and decided to undergo an upper cervical chiropractic evaluation.

During her evaluation, an upper neck injury was discovered, which was likely caused by the trauma from the waves. Because this patient had traveled from a distance to undergo the evaluation, her family decided to have her stay in the area for 7 weeks to be treated. After her first upper cervical adjustment, the fainting stopped. By the second week of care, her headaches began to diminish. In addition, she began to sleep better and felt more energetic. At the end of seven weeks, all fainting, headaches, and insomnia were absent. She felt healthy, happy, and energetic.

Female, Age 56 years, Neck Pain, Headaches, Chronic Fatigue

This 56-year-old female suffered from chronic neck pain, headaches, and fatigue for years. She thought the problems may have started sometime after an auto accident she experienced 14 years before. During the accident, she was hit head-on and totaled her car. The pain bothered her on and off for years– sometimes on a daily basis and other times a month would go by without pain. She tried many practitioners such as massage therapists and chiropractors and received some relief but still the problem continued year after year. Finally, after struggling over a decade, she sought help from upper cervical chiropractic care.

During her upper cervical chiropractic exam, an upper neck injury was found, most likely stemming from her auto accident. Unfortunately the injury had never been addressed by any of her previous practitioners. After only 3 upper cervical adjustments, her neck injury was corrected. All neck pain, headaches, and fatigue healed and never returned.

Female, Age 49 years, Chronic Fatigue Syndrome

This 49-year-old female suffered from chronic fatigue syndrome for approximately four years prior to seeking help from upper cervical care. She tried many therapies, including vitamins, herbs, and chelation with no results. She also suffered with neck pain and stiffness for four years as well.

During her upper cervical chiropractic exam, an upper neck injury was discovered. When questioned as to traumatic events in her past that could have caused the neck injury, she recalled a fall down the stairs in which she fractured her tailbone. The fall preceded the onset of chronic fatigue by just a few months. After only one month of upper cervical care, the neck pain and fatigue were absent.

Female, Age 43 years, Fibromyalgia and Chronic Fatigue Syndrome

This 43-year-old female suffered with chronic pain and fatigue for over two decades before finally being diagnosed with fibromyalgia and chronic fatigue syndrome. She tried physical therapy, water therapy, medications, and massage to no avail. Her pain and fatigue levels had caused her to quit work as a seamstress because lifting bolts of fabric, etc. had been too painful for her.

During her upper cervical chiropractic evaluation, an upper neck injury was discovered. She was questioned as to past traumatic accidents and remember two severe auto accidents that preceded the onset of fibromyalgia and chronic fatigue symptoms-one rollover auto accident and one in which she was rear-ended at 70 mph. After two months of upper cervical care, due to the fact that her sleep had improved tremendously, her energy was increased, and her pain levels were greatly reduced, she was able to return to work as a seamstress without pain.

Female, Age 46 years, Fibromyalgia, Neck Pain

This 46-year-old female suffered from chronic pain in her neck, arms, shoulders, and legs for seven years before seeking help from upper cervical care. Her fibromyalgia diagnosis followed closely after an accident in which a 22-pound briefcase fell from an overhead bin in an airplane and landed on her head. Because she worked at a computer all day, her work was greatly impaired by pain in her neck and arms. She was forced to work reduced hours, suffered in pain on a daily basis, and took many pain and sleep medications to combat the pain.

During her upper cervical chiropractic examination, an upper neck injury was found, which probably stemmed from her overhead bin luggage accident. After several months of upper cervical care, her pain was greatly reduced and she was able to return to full hours at work. On days where she did not work at the computer at all, she was pain-free.

Female, Age 40 years, Fibromyalgia, Neck and Back Spasms

After suffering for 16 years with chronic neck and back pain, this 40-year-old female was diagnosed with fibromyalgia. Her neck and back spasmed frequently so that she was forced to stop whatever she was doing, lie down, apply ice, and take painkillers. Sometimes she was bedridden due to the pain and spasms. Also, she frequently had trouble sleeping and could lie awake for hours every night.

At this patient’s initial consultation, she claimed she had always believed her problems were coming from her neck because she had sustained several injuries to her neck prior to the onset of her symptoms. She had suffered a whiplash auto accident, a fall on a waterslide, and a sledding accident. She had tried numerous practitioners over the years to fix her neck injury but nothing was successful. Finally she was referred for an upper cervical chiropractic examination.

During her upper cervical exam, an upper neck injury was discovered, which was still present despite her previous treatments and therapies. During her first two months of care, the pain levels lessened and spasm episodes decreased. In addition, she began to sleep through the night and felt increased energy and well being. Several months later, she was free of pain and muscle spasms.

Female, Age 49 years, Dizziness, Chronic Fatigue

This 49-year-old female suffered from dizziness and chronic fatigue syndrome for 5 years. Both symptoms occurred on a daily basis. She tried many forms of therapy including chelation with hydrogen peroxide and vitamin C but showed the same high Epstein Barr titers in follow-up tests.

During her chiropractic examination, an upper neck injury was discovered. When questioned as to possible traumatic events in her past that could have caused the neck injury, she remembered falling head over heels down her basement stairs approximately five years prior (the same time her symptoms started). She also was involved in an accident two years prior in which her car air bag deployed accidentally. After her first upper cervical adjustment, all dizzy spells stopped. She also noticed experiencing more restful sleep and better energy throughout the day. One month later, she had no reoccurrence of symptoms.

Male, Age 34 years, Head Injury, Whiplash, Headaches, Sleep Disorder, Fatigue

This 34-year-old male suffered a head injury during an auto accident in which he was rear-ended at 50mph. He described severe pain in his neck and back and headaches that originated at the base of his skull and spread to his left eye. His pain was so severe that it prevented him from sleeping, so he suffered from severe fatigue. To maintain some level of function during the day, he relied on multiple caffeinated beverages such as jolt or bull colas and/or coffee. At the time of his initial upper cervical chiropractic evaluation (14 months after the accident), he had been suffering with all of the above symptoms for over a year. He had sought help from numerous practitioners including physicians, neurologists, and therapists, to no avail. He reported receiving some temporary relief from Pilates.

During his evaluation, an upper cervical injury was discovered, which had likely been caused by his auto accident. After the first month of care, be began to notice less pain and a slightly better ability to sleep. By the third month of care, he was reporting a larger reduction in pain levels, which was enabling him to resume exercising. After six months, all pain was absent, normal sleep was resumed, and he was able to participate in all previous activities and sports, including working full-time.

Male, Age 25 years, Post Auto-accident Neck Pain, Headaches, Numbness in Hands, Fatigue

After an auto-accident last spring, this 25-year-old male experienced spinal pain, fatigue, restlessness, headaches, and numbness in his hands for the last 6 months. After the first adjustment, his symptoms improved substantially. One month later, he did not need to be adjusted again and all of his symptoms were completely gone. Eighteen months later, he had no return of symptoms.

Female, Age 31 years, Fatigue, Sleep Disorder

This 31-year-old female described such extreme fatigue and trouble sleeping that she required 3 different alarms to get her out of bed each morning for work. This had been going on for years and she could remember having trouble as far back as age 16.

During her evaluation, an upper cervical injury was discovered. She reported that she had had a difficult birth requiring forceps and thought that perhaps might have been the original cause of her neck injury. After the first adjustment, she immediately began sleeping better. Several weeks later, she reported being able to wake up before her alarms went off and she felt energetic and well-rested.

Male, Age 31 years, Chronic Fatigue Syndrome

This 31-year-old male suffered from chronic fatigue syndrome for the previous 10 years. He reported that the fatigue started after a bike accident in which he flew over his handlebars and landed on his head and shoulder. Besides fatigue, he reported that he began sleeping 10 hours per night and still felt tired during the day; that he had trouble concentrating; and that he would fall asleep during the day. Even with all of the sleep, he felt extremely fatigued and could only work part-time. Physical exercise was impossible in that he would feel even more fatigued after attempting it. He tried supplements and various special diets and improved slightly over the years to the point that he could work a full-time job. But he stated that he still required 10 hours of sleep per night and still didn’t feel refreshed. He decided to undergoing an upper cervical chiropractic evaluation because he knew the fatigue had started after his bike accident and he wondered whether he had injured his neck.

During his evaluation, an upper cervical injury was discovered through thermography and radiography. He began treatment and noticed improvements in his energy levels and sleep patterns within the first 2 weeks of care. By the end of the first month, he reported that he was sleeping more deeply and was feeling refreshed when he awakened in the morning – the first time in 10 years. Several months later, he felt well enough to go on 30-mile bike rides without feeling fatigued; all signs of fatigue and sleep disorder were absent.