Doctor You: Natural Therapies for Fibromyalgia
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Facing a string of days filled with pain, and nights lacking restorative
sleep can be terrifying. A disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues, fibromyalgia is a modern-day plague, disheartening to those who suffer from it.
Those who have studied fibromyalgia believe that fibromyalgia has to
do with the nervous system, which seems to amplify painful sensations by affecting the way a sufferer’s brain processes pain signals. Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress, and some sufferers notice symptoms after receiving a vaccine. In other cases, symptoms gradually accumulate over time with no single triggering event.
Women are much more likely to develop fibromyalgia than are men, and there may be a bias toward diagnosing women. Doctors tend to look for a physical issue in men describing symptoms associated with fibromyalgia, while women are often thought to be experiencing psychosomatic
The role of oxidative stress in Fibromyalgia
Fibromyalgia is a sort of general malaise that can impact nearly every
area of life. The “brain fog” that often accompanies fibromyalgia is
debilitating to people who have been accustomed to mental acuity, and
have been able to rely upon their mental abilities. Many people who
have fibromyalgia also have tension headaches, temporomandibular
joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.
In addressing fibromyalgia, a variety of supplements can be helpful.
Exercise, relaxation and stress-reduction measures also may help.
Symptoms of Fibromyalgia
The pain associated with fibromyalgia often is described as a constant
dull ache, typically arising from muscles, which are said to feel like
they have been pulled or overworked. However, fibromyalgia can also
feel like a deep bone ache, pins and needles, or a stabbing or burning
pain. There are times this pain is mild, others when it is so severe that it
becomes unbearable. To be considered widespread, the pain must occur
on both sides of your body and above and below your waist. Fibromyalgia
is characterized by additional pain when firm pressure is applied to
specific areas of your body, called tender points.
Tender point locations include the following, with locations on left and
right sides of body adding up to eighteen total tender points:
- Back of the head
- Between shoulder blades
- Top of shoulders
- Front sides of neck
- Upper chest
- Outer elbows
- Upper hips
- Sides of hips
- Inner knees
If these symptoms are present with pain at eleven of the eighteen points,
according to the American College of Rheumatology, a person can be
said to have fibromyalgia. However, because fibromyalgia symptoms can
come and go, and there is some uncertainty about how much pressure
to apply during a tender point exam, less stringent guidelines have been
developed for doctors to use in general practice. These newer diagnostic
criteria include widespread pain lasting at least three months with no
other underlying condition that might be causing the pain. To determine
that there are no other underlying conditions, some doctors may
ask a patient to have blood tests to check the blood count, and to test
such things as the erythrocyte sedimentation rate, and thyroid function.
Natural therapies for overcoming Fibromyalgia
Fatigue and Sleep Disturbances
People with fibromyalgia often awaken tired, even though they report
sleeping for long periods of time. When they can sleep, their sleep is
frequently disrupted by pain, and many people with fibromyalgia have
other sleep disorders, such as restless legs syndrome and sleep apnea,
that can make symptoms even worse, and make recovery difficult. As
stated earlier, many people who have fibromyalgia also may have: fatigue,
anxiety, depression, endometriosis, headaches, and irritable bowel
What Are the Causes and Risk Factors Relating to Fibromyalgia?
Doctors don’t know what causes fibromyalgia, but some evidence indicates
that it involves a variety of factors working together:
Genetics: fibromyalgia seems to run in families so it’s possible that certain
genetic mutations may make a person more susceptible to developing
Infections: some illnesses appear to trigger or aggravate fibromyalgia.
Physical or emotional trauma has been linked to the onset of fibromyalgia.
Post-traumatic stress disorder has also been linked to fibromyalgia.
There are some common characteristics among people who develop fibromyalgia.
One is the person’s gender. Fibromyalgia is diagnosed more
often in women than in men. Female reproductive hormones may play a
part in how women experience pain.
Above the fact is stated that fibromyalgia seems to run in families,
which implies that a person may be more likely to develop fibromyalgia
if a relative also has the condition.
Rheumatic disease is something else fibromyalgia sufferers tend to have
in common, which means such an illness can be considered a risk factor.
If you have a rheumatic disease, such as rheumatoid arthritis or lupus,
you may be more likely to develop fibromyalgia.
Why Is the Pain There; Why Does It Hurt?
People who have studied fibromyalgia have put forth a theory that it is
due to central sensitization. This theory states that people with fibromyalgia
have a lower threshold for pain because of increased sensitivity
in the brain to pain signals. Like an overstimulated child, an overstimulated
nervous system can seem to become even more active; repeated
nerve stimulation causes the brains of people with fibromyalgia to
change. This change involves an abnormal increase in levels of certain
chemicals in the brain that signal pain (neurotransmitters). In addition,
the brain’s pain receptors seem to develop a sort of memory of the pain
and become more sensitive, meaning they can overreact to pain signals.
It’s as if there is a sort of repeating loop of pain sensations.
Conventional (Drug) Treatments
The best conventional medicine has to offer is an effort at minimizing
symptoms and improving general health. Medications are advised that
can help reduce the pain of fibromyalgia and improve sleep. Common
Analgesics: Acetaminophen (Tylenol, others) to ease the pain and stiffness
caused by fibromyalgia.
Tramadol (Ultram) is a prescription pain reliever that may be taken
with or without acetaminophen.
Doctors often recommend non-steroidal anti-inflammatory
drugs(NSAIDs) — such as ibuprofen (Advil, Motrin, others) or naproxen
sodium (Aleve, others) — in conjunction with other medications.
Antidepressants such as Duloxetine (Cymbalta) and milnacipran
(Savella) are thought to help ease the pain and fatigue associated with
fibromyalgia. Doctors sometimes prescribe amitriptyline or fluoxetine
(Prozac) to help promote sleep.
Anti-seizure drugs: medications designed to treat epilepsy are often useful
in reducing certain types
of pain. Gabapentin (Neurontin) is sometimes helpful in reducing
fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved
by the Food and Drug Administration to treat fibromyalgia.
Dangers of NSAID drugs
Many of those Drugs are Dangerous
Acetaminophen and NSAID Toxicity
Over-the-counter drugs are a significant source of morbidity and mortality
in the United States, with approximately 65,000 deaths annually
due to them. Based on their heavy use it seems that few people are aware
of the dangers posed by common OTC (over-the-counter) medications,
especially acetaminophen and nonsteroidal anti-inflammatory drugs
(NSAIDs) such as ibuprofen and naproxen. Acetaminophen
and NSAIDs commonly cause serious liver and gastrointestinal side
effects–some permanent–yet most people have no idea how dangerous
they can be. Because these strong medications are available without prescriptions,
and heavy television and magazine advertising never mention
the potential side effects of cold medicines, pain killers, antihistamines,
and other ubiquitous drugs, there seems to be general ignorance of their
inherent dangers. In fact, OTC medications as a category are responsible
for more than 150,000 hospitalizations every year, according to the
Food and Drug Administration, and almost 1000 OTC medications
have been linked to liver toxicity, which causes about 2000 deaths annually
in the United States.
Found in more than 100 OTC preparations, including Sudafed®, Theraflu
®, and Tylenol®, acetaminophen is used to reduce pain and fever. It has
been available in the United States since 1960. Unlike NSAIDs, acetaminophen
does not reduce inflammation or blood clotting or cause
gastric complications. However, acetaminophen overdose is one the
most common causes of OTC drug poisoning in the United States and
Britain. More than 30,000 cases of acetaminophen overdose are reported
to the American Association of Poison Control Centers per year. It is
a leading cause of liver failure in
the Western world and, according to Bartlett, the leading cause of druginduced
liver failure in the United States.
People who have liver disorders or who consume large amounts of alcohol
are advised to avoid acetaminophen, which can damage both the
kidneys and the liver, even at therapeutic doses. People who use acetaminophen
on a regular basis double their risk of kidney cancer
NSAIDs and Aspirin
NSAIDs are common medications used to reduce pain and inflammation.
They are available as both OTC medications (e.g., ibuprofen
and naproxen, or Aleve®) and prescription drugs (e.g., cyclooxygenase
enzymes, some of which are called COX-2 inhibitors). Because of the
elevated risk of heart attack
and stroke, several prescription COX-2 inhibitors, including Vioxx®
and Bextra®, were removed from the market by their manufacturers
in late 2004 and early 2005. Celebrex®, a prescription COX-2 inhibitor,
remained on the market, but the Food and Drug Administration
demanded that its manufacturer add a
strong, prominent warning to the package detailing the elevated risks of
heart attack and stroke. But OTC NSAIDs were not implicated in these
studies and so remain widely available. All told, more than 30 billion
doses of NSAIDs are consumed annually in the United States alone.
Ibuprofen, the most common OTC NSAID, can be found in scores of
products or as a single-formulation drug. Even at
nontoxic levels, NSAIDs damage tissue in the gastrointestinal tract,
inhibit the function of platelets (blood cells that aid in coagulation and
homeostasis), and alter kidney function.
Even at normal NSAID dosages, people with compromised kidney
function can develop NSAID toxicity. A standard CBC/Chemistry
blood test that measures creatinine, blood urea nitrogen (BUN), and
the BUN-to-creatinine ratio can help detect NSAID-induced kidney
toxicity. If any of these blood markers of kidney damage is elevated,
discontinuing NSAIDs and acetaminophen may result in a reversal of
the kidney damage.
NSAIDs cause gastric side effects by inhibiting the COX-1 enzyme.
This causes mucus production to decrease in cells lining the gastrointestinal
tract, leaving it vulnerable to gastric acid, bile, enzymes, and
alcohol. Gastrointestinal injury ranges from heartburn, nausea, and
abdominal pain, to more serious complications such as ulcers, hemorrhage,
and fissures (tears in the tissue).
Talk therapy; talking with a counselor, can help strengthen a fibromyalgia
sufferer’s belief in his / her abilities and teach him / her strategies
for dealing with stressful situations so stress doesn’t turn inward, compounding
Though not written specifically about fibromyalgia, the book When the
Body Says No: Understanding the Stress – Disease Connection by Gabor
Mate, MD, can help with understanding how stress impacts physical
Self-care is critical in the management of fibromyalgia. Reducing stress
is critical. Develop a plan to avoid or limit overexertion and emotional
stress. One aspect of self care is finding enjoyment, fulfillment, satisfaction;
fun. Allow time for relaxation every day. That may mean learning
how to say no without guilt. Completely altering the schedule may be
unwise though. People who remain active tend to fare better than those
who drop all activity. Stress management techniques, such as deepbreathing
exercises or meditation are often helpful.
Time for enough sleep must be found. Because fatigue is one of the
main characteristics of fibromyalgia, getting sufficient sleep is essential.
Observing a regular time for going to bed and getting up can be helpful
in getting a good night’s sleep. Napping can interfere with sleep cycles,
and might make falling asleep at night more difficult.
Though at first it might increase pain somewhat, exercise is proven to
help in recovery. Practicing the same exercise routine can help to build
stamina and prevent overexertion. An exercise routine should include
Stretching, such as moderate yoga or Pilates
Cardio wourkout, such as walking, running, dancing or swimming
Resistance training, such as lifting weights, or Pilates Reformer
Moderation will play a significant part in exercise being beneficial rather
than harmful. Moderation means not “overdoing it” on your good days,
as well as not self-limiting or doing less on the days when symptoms
In a controlled trial, a program consisting of two 25-minute exercise
classes plus two educational sessions per week for six weeks resulted in
immediate and sustained improvement in walking distance, fatigue, and
well-being in a group of people with fibromyalgia, although no reductions
in pain, anxiety, or depression were seen.
In a more recent controlled trial, a 35-minute exercise program in a
warm pool once a week for six months, coupled with counseling sessions,
led to improvements in hand-grip strength and endurance, as well
as to reductions in pain, distress, depression, and anxiety.
Maintain a healthy lifestyle
Because fibromyalgia is stress-related, it can be helpful to limit caffeine
intake, since caffeine can contribute to stress. Eat healthy foods (more
natural / organic foods and fewer processed foods). Trying a vegan diet
may be helpful as well. A vegan diet (includes no animal products) that
is also low in salt may help women with fibromyalgia. Avoiding MSG
may be helpful. In one report, women with fibromyalgia experienced
improvement or complete resolution of their symptoms after eliminating
MSG or MSG along with aspartame from their diet.
Since stress aggravates or increases symptoms of fibromyalgia, stress-reduction
techniques, such as meditation, have proven helpful in preliminary
Acupuncture may be useful for short-term relief of fibromyalgia symptoms.
In one preliminary trial, acupuncture produced a significant
decrease in pain and point tenderness along with related biochemical
changes measured in the fibromyalgia patients’ blood.
Another uncontrolled trial used electroacupuncture (acupuncture
with electrical stimulation) treatment in people with fibromyalgia who
were unresponsive to conventional medical therapies. After an average
of seven treatments per person, 46% claimed that electroacupuncture
provided the best relief of symptoms when compared to all other
therapies, and 64% reported using less pain medication than prior to
electroacupuncture. A double-blind trial compared fake acupuncture to
electroacupuncture and reported significant differences in improvement
in five of eight outcome measurements among people with fibromyalgia.
Short-term pain reduction in people with fibromyalgia has been reported
in other studies, some of which were at least partially controlled;
however, long-term benefits have never been investigated in a controlled
clinical trial. Long-term controlled trials are necessary to conclusively
determine whether acupuncture is a useful treatment for fibromyalgia.
Joint manipulation, chiropractic, and related treatments may be helpful
for relieving some of the symptoms of fibromyalgia. A preliminary study
found that almost half of people with fibromyalgia who received chiropractic
care had “moderate to good” improvement. A small preliminary
the effect of four weeks of chiropractic treatment (three to five times per
week) consisting of soft tissue massage, stretching, spinal manipulation,
and general advice and information. Treatment resulted in a significant
decrease in pain and an increase in range of neck movement, but there
was no improvement in tender points or in ability to function in daily
Another preliminary trial evaluated a longer treatment period (30 sessions)
consisting of spinal manipulation and deep pressure massage to
tender points in the muscles. More benefit was reported by this study,
as 60% of the patients experienced significant pain reduction, reduced
sensed of fatigue, and improved sleep. These benefits persisted one
month after the treatment was completed. People who did not feel
better after 15 treatments were not likely to benefit from this type of
treatment. No controlled research has evaluated manipulation therapies
5-HTP 100 mg TID: Supplementing with 5-HTP may ease symptoms
NOW Foods 5-HTP 100mg, 120 VCaps
Acetyl-L-Carnitine 1,500 mg daily for ten weeks: Supplementing with
acetyl-L-carnitine may improve musculoskeletal pain, depression, and
general health in people with fibromyalgia
Jarrow Formulas Acetyl L-Carnitine 500mg, 120 Vegetarian Capsules
SAMe 800 mg daily: Supplementing with SAMe may increase serotonin
levels in the blood and help relieve symptoms
Nature Made SAM-e Complete 400 mg – 60 Enteric Coated Tablets
Magnesium: A preliminary trial found that a combination of magnesium
and malic acid might lessen pain in people with fibromyalgia
Nature Made High Potency Magnesium 400 mg – 150 Liquid Softgels
Malic acid: A preliminary trial found that a combination of magnesium
and malic acid might lessen pain associated with fibromyalgia.
Nature’s Life Malic Acid , 800 Mg, Mineral Chelating Agent, 250 Veg Capsules
Melatonin: In one study, supplementing with melatonin reduced tender
points and improved sleep in people with fibromyalgia
Melatonin 5mg Time Release by Natrol – 100 Tablets
Vitamin B1: People with fibromyalgia may be deficient in vitamin B1;
supplementing with the vitamin may correct the deficiency and improve
Source Naturals B-1 High Potency 500mg with Mag, 100 Tablets
Vitamin: Vitamin E was used in one early study with beneficial and
sometimes dramatic results
Kirkland Signature Vitamin E 400 IU, 500 Softgels
Doctor You: Natural Therapies
Learn to be your own doctor: Doctor You
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