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March 7, 2003
By Dr. Michael Vesely, D.C.
Fibromyalgia is a disorder of complexity. According to the diagnostic criteria for Fibromyalgia Syndrome (FMS) published by the 1990 American College of Rheumatology (ACR), fibromyalgia patients must have:
1. Widespread pain in all four quadrants of the body for a minimum of three months.
2. At least 11 of the 18 specific tender points.
Although the above criteria, created for research purposes, focuses on tender point count, a recent consensus of 35 FMS experts has determined that a person does not need to have the required 11 tender points to be correctly diagnosed and properly treated for FMS.
Many people who have less than 11 of the required tender points may still be diagnosed with FMS as long as they have widespread pain and many of the common symptoms associated with FMS. Commonly associated symptoms include:
• Fatigue
• Sleep disorder (or sleep that is unrefreshing)
• Jaw pain (TMJ dysfunction
• Post-exertion malaise and muscle pain
• Numbness and tingling
• Skin sensitivities
• Morning stiffness
• Irritable bowel
• Chronic headaches (tension type or migraines)
• Cognitive or memory impairment
• Menstrual cramping and PMS
• Dizziness or impaired coordination.
Sleep - the most important aid in alleviating the symptoms of fibromyalgia. The better you sleep the better you will feel.
Natural Sleep – There are many natural ways to help you sleep:
Magnesium – aids in smooth muscle relaxation
Melatonin
Valerian Root
Combination formulas – may contain both of the ingredients above plus others.
Homeopathic sleep remedies
5-HTP - This nutritional supplement has been proven to reduce fibromyalgia pain and tender points. It also helps reduce morning stiffness, improve sleep patterns, anxiety and fatigue.
Medicated Sleep – For many people, herbal remedies don't help them achieve restorative sleep. It is important to see your physician to find a medication that will aid in a better night's sleep. Try to find a medication that will allow you to sleep, but not feel groggy in the morning. Please be sure to consult your physician before taking any medication.
Amitriptyline – This medication works primarily by improving Stage 4 sleep, the sleep disturbance thought to underlay fibromyalgia. This is the drug of choice for many patients with severe sleep disturbance and deprivation issues.
Other drugs prescribed include:
Xanax or Valium
Flexeril
Trazadone
Ambien
Nortriptyline
Doxipen
Norflex
Prozac
Zoloft
Paxil - and others.
Muscle Pain
Natural Pain Relief
Massage and Chiropractic – Studies have shown that fibromyalgia patients prefer massage therapy and chiropractic care to many other forms of treatment.
Massage: fibromyalgia can cause muscle spasms and muscle imbalances and range of motion can be restricted. Massage therapy can help reduce trigger point pain. It also can give you a wider range of motion and more energy. Massage therapy is a great tool for healing and recovery. It also helps maintain the alignment adjustments you receive from your chiropractor.
Chiropractic Care: [It is the author's opinion that] chiropractic adjustments are valuable to your improvement and recovery. If your skeletal structure isn't properly aligned, this can cause you pain and make you vulnerable to disease. It can also worsen your fibromyalgia symptoms. Maintaining proper alignment can help reduce your pain and speed your recovery.
Magnesium - studies have shown patients with FM have low levels of magnesium. Magnesium aids in synthesis of ATP (your body's energy source) and smooth muscle relaxation.
Acid Alkaline Balance – Active Greens – see acid alkaline balance information below.
Yoga – helps to relax the mind and gently stretch the body.
Medicated Pain Relief – for many individuals, chronic pain creates a cycle of muscular spasm and further lack of sleep. There are many safe prescription medications available today to help you cope with the pain. Options include:
Over-the-counter medications
--Advil
--Aleve
Prescription medications
--Flexeril – muscle relaxant
--Skelaxin – muscle relaxant
--Neurontin - This anticonvulsant drug has been used successfully to reduce neuropathic pain.
Poor Mood
Natural support:
--5-HTP
--St. John's Wort [Editor's note: Be sure to consult with your physician before taking St. John's Wort, as it may interact with any prescription medicines you are taking.]
Medication – Antidepressants – Please consult your physician:
--Zoloft
--Prozac
--Celexa
Stomach and Digestive Problems:
Natural methods – balance acid/alkaline blood. Use pH test strips to test urine pH. Will also help with muscular pain and sleep pattern alignment. See acid alkaline balance below.
Stress – Emotional, Physical, Chemical stressors
Emotional – Modern living is stressful!
Psychotherapy – can help with short and long term emotional stress
Yoga – Helps to quiet the mind and relax the body
Pilates – private training regimen developed for dancers that elongates the muscles and focuses on trunk core strengthening
General Exercise – helps to move the joints, circulate the blood and burn stored stress
Physical – avoid physical activity that can aggravate your condition. Use positive forms of exercise to help alleviate symptoms. Remember, a little bit of exercise is good, but too much can aggravate your symptoms.
Yoga
Pilates
Massage and Chiropractic
Chemical – toxins in the body can cause a flare up of symptoms
Diet – Eat a low sugar/carbohydrate diet. Numerous studies have shown that high carb diets result in flare-up of FM symptoms.
Getting in Balance: Alkalinity and Acidity
In its natural, healthy state, our body is slightly alkaline — the opposite of acidic. In fact, our blood and cells depend on remaining in this slightly alkaline state for our very survival. For example, to produce energy from the food we eat, a healthy cell requires abundant oxygen—an alkalinizing element. A healthy cell also contains alkaline minerals like potassium.
If we could only maintain this state, then many of the physical and emotional problems that plague us — including fatigue, headaches, chronic illnesses, colds, flu, even an inability to think clearly—might rarely appear. But the reality is that everything we're exposed to, from the foods we eat to the sports we play to the pollutants we encounter, produce acidic chemicals, tipping us out of our ideal acid/alkaline balance and resulting in a long list of physical and emotional ailments.
We can handle this fairly well when we're young. In youth, our body is pretty good at buffering the acidic effects of the foods we eat and the life we live because our lungs and kidneys are strong, our bones rich in alkaline minerals, and our blood good at buffering acidity.
But as we age and experience increasing amounts of the acid-causing stresses of modern life, it becomes more and more difficult for our bodies to naturally buffer the effects. One reason for the decline is simply the normal aging process. But strenuous athletic activity, years of stress, or even a lifetime of eating the standard, nutritionally bereft Western diet, can hasten this loss of buffering ability.
The good news is that by making relatively minor changes in your diet and lifestyle, you can bring your acid/alkalinity into a healthier balance, regardless of your age, and live a healthier life in the process.
First though, you need to figure out where you lie on the acid/alkaline spectrum. [Editor's note: LA Health Center, where the author works, is one place where you can have your acidity/alkalinity evaluated.]
Buffering Capability
Buffering is your body's ability to restore balance between alkaline and acidity. There are numerous ways your body buffers acidity. Your blood contains three buffering systems designed to keep it to its tightly regulated, slightly alkaline pH of 7.35 to 7.45. Your lungs and kidneys help eliminate acid substances when acid levels rise too high, and preserve alkaline substances. The reverse occurs if you become too alkaline.
If you become too acidic, your body will leach alkaline minerals from your bones to maintain the slightly acidic pH of the blood. This can increase your risk of osteoporosis.
Final Thought
When you have been diagnosed with fibromyalgia you will understand that there is not a single medication, a single exercise or a single diet that will offer a “cure.” You must experiment with different medications, different exercises, different diets and different lifestyle approaches until you find out what works for you.
Reprinted with permission of the author. (c) 2003 LA Health Center.
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