Fibromyalgia

A doctor can perform an exam showing that there are at least 11 of 18 identified specific locations around the body that patients tend to feel tenderness at. This would clinch the formal diagnosis, but in the real world, if a patient has the characteristic type of pain and associated symptoms of Fibromyalgia, the clinical diagnosis is made without strict adherence to the number of eleven tender spots to use in the diagnosis, as defined in the diagnostic criteria.

Possible Associated Symptoms besides Pain

Along with  pain, there are many associated symptoms associated with Fibromyalgia, such as  anxiety and depression, chronic headaches, dryness in mouth, nose, and eyes, sensitivity to cold and/or heat, inability to concentrate, irritable bowel syndrome, numbness or tingling in the fingers and feet, poor circulation in hands and feet (Raynaud's phenomenon), restless legs syndrome, and stiffness -- any combination of which can all occur in patients with Fibromyalgia.

Currently, there is no clearly known single cause or one cure for the variety of problems and multiple symptoms that are associated with and manifested by Fibromyalgia. So, it is no wonder that these patients are have a difficult condition to bear and their doctors are aware that fibromyalgia proves to be a  difficult condition to try to treat.

The question to ask at this point is, "If there is no clear treatment, then what can be done?"

Where Integrative Medicine is Essential

There are two medications that have been approved by the FDA for Fibromyalgia pain, Cymbalta and Savella. Both have the chemical characteristics of antidepressants. A variable effect has been found in patients, and although helpful for some, these are not the real answer to this problem.

Doctors treating this need to think "out of the box" with regard to natural therapies including dietary approaches that provide so much more than simply using medications for symptom relief. To even attempt to heal the person's system as  a whole, a holistic approach taking into account mind-body connection, dietary and lifestyle influences  and the like, provides the best hope for sufferers.

Attending to underlying food and other environmental sensitivities is crucial for many people who suffer from fibromyalgia. Dietary control by temporary elimination of problem foods and immunotherapy for sensitivities to  foods, mold, dust and other allergens can make a dramatic difference for some.

Nutritional deficiencies are common and the use of both oral and intravenous vitamins are used for these patients with benefit.

A complete evaluation of Fibromyalgia sufferers requires a thorough investigation of hormonal balance. Many people without an overt proven medical condition, such as hypothyroidism, are still found to have suboptimal levels leading to the patient being untreated.  Striving for optimized levels and consideration of adrenal stress and borderline dysfunction, is not emphasized in most medical offices which do not routinely care for Fibromyalgia -- and Chronic Fatigue Syndrome -- patients.

Getting adequate rest for the body through restful sleep is an essential element in caring for these patients. There are a number of methods to enhance sleep before resorting  to medications as a last resort. The first and simplest, and unfortunately the least used, practice is deep breathing techniques or some form of meditation to reduce stress and   help insomnia.
 
A nutritional supplement approach number is successful for many with disturbed sleep using  amino acids like  5-HTP, GABA,  l-glycine and theanine. There are many helpful  herbal compounds  that can be safely tried. These could include valerian root, passion flower, hops, chamomile, and skullcap.

Melatonin, a hormone, is a well-known sleep aid, and hormonal balancing may help sleep not only for menopausal women but in younger women and for men as well.

A safe technology of note is called CES (Cranial Electrical Stimulation.) It allows the user of a  small home device to create a more relaxed pattern of brain waves which promotes sleep in insomnia sufferers, and also provides general daytime relief of stress.

A related technology  provides pain relief through electrical stimulation of affected body parts, and both modalities can be used for those who suffer from the pain of Fibromyalgia, and the insomnia and stress which inevitably accompanies their pain.

Infections may play a  role in others  and needs to be considered by physicians. In the  northeast particularly, the possibility of underlying Lyme's disease should be evaluated. In that case labs specializing in infectious disease testing should be consulted, as the known percentage of "false negative" tests is too high. Unfortunately a "false negative" test, meaning that the person tests negative despite having the problem being tested for, has been proven to commonly occur in Lyme disease.

Other infections, such as to Epstein-Barr Virus and other viruses, or to Candida yeast, are common associated factors in Fibromyalgia, as well as in Chronic Fatigue Syndrome. The integrative approach to infections involves not only specific measures which can be taken against the infectious agent, but enhancement and monitoring the status of immune functioning of the patient.

In summary,  the causes of Fibromyalgia -- and Chronic Fatigue Syndrome -- are many, and the applied therapies can be many as well.

Whichever may be the most prominent factor - hormonal imbalance, infections, food, or  stress and sleep problems, the best approaches is to address everything in an interrelated treatment program, individually tailored to address the needs of the variety of people who suffer from these common and often debilitating conditions. With this approach there is hope and effective treatment.

Henry C. Sobo, M.D. practices Integrative Medicine in Stamford, CT.