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DEALING WITH FIBROMYALGIA IS NO SIMPLE TASK

Fibromyalgia Tender Point Chart – Image: The Institute for Functional Medicine

Fibromyalgia (widespread muscle pain) has remained difficult to treat for many years. It commonly occurs in females over males by a 20-to-one ratio and is characterized by general pain, fatigue, depression, headaches, insomnia, anxiety, gastrointestinal issues  and morning stiffness. The classical definition (from 1990) is when 11 out of 18 specific tender points are present. Pain has to last at least three months and cannot be explained any other way. It usually occurs at specific points above and below the navel and is not related to trauma or rheumatic disease. In 2010, the American Academy of Rheumatology broadened the definition, which now includes many more conditions that may not truly be fibromyalgia.

That decision is important because someone given that diagnosis will be consigned to lifelong prescription medications (and subsequent addictions) such as narcotics, sleeping aids and antidepressants, which may help, but in turn cause many other problems. Thus, it is important to make the right diagnosis. Also realize that many natural options are available. Many times, patients can be weaned off medications.

Conditions to be ruled out by a physician before a diagnosis of fibromyalgia is given include chronic infections (Lyme, hepatitis C, mycoplasma) and other viruses; rheumatic conditions (rheumatoid arthritis, lupus); thyroid disease (many times undiagnosed, or if diagnosed, treated poorly); nutritional imbalances: low vitamin D (epidemic, especially to those living in the Midwest with only small amounts of winter sun exposure); low magnesium; low B vitamins; low selenium; low manganese; issues with blood sugar; xenobiotics such as heavy metals, pollutants (how much we carry in our bodies); blood disorders (especially too much or too little iron); neurotransmitter disorders (serotonin, norepinephrine); and sleep disorders.
Many triggers could be present if fibromyalgia is properly diagnosed such as injury, accident, cervical trauma, surgery, chemical exposure, environmental, emotional trauma, infections, sleep deprivation, hormonal imbalances, psychological issues (PTSD) and muscle skeletal disorders (myofascial pain or disc disease).

Once the diagnosis of fibromyalgia has been confirmed, a systematic approach is needed to be able to improve patient well-being and minimize the use of dangerous prescription medications. A functional medical approach addresses each of the different body systems; first being the gastrointestinal system. New research is showing some light on the presence of small intestinal bacteria overgrowth (SIBO) as the underlying issue in patients with fibromyalgia, chronic fatigue syndrome and complex regional pain syndrome (CRPS). Special tests can be done and treatment many times resolves a lot of the pain.

Diet and nutrition are crucial. Food allergies are rampant, especially gluten sensitivity, so either a food elimination diet of the main allergies and/or blood testing can uncover many allergies or intolerances to many foods. Also, the intake of chemicals, additives, pesticides and MSG should be eliminated by a patient. Any chronic infection should be ruled out, such as viruses, parasites, yeast and bacteria. Mitochondria, which are the powerhouse of every cell, usually become defective in a fibromyalgia patient. Lifestyle modification can reduce stress and help with proper sleep (via biofeedback, prayer, meditation or yoga). It’s also important to address all hormonal imbalances: thyroid, female or male hormonal issues and stress hormones (cortisol).

After a diagnosis, it’s key to start a good program of detoxification supervised by a qualified physician, because some over-the-counter programs can be counterproductive. Also, there may be many neurotransmitter imbalances as the brain and nervous system communicate with the rest of the body (low serotonin, cortisol, catecholamines). Along with the detox, it can be helpful to start a mild aerobic exercise program and gentle stretching.
Drugs sometimes help fibromyalgia symptoms, but can cause addictions, alter quality of life and never address the underlying problem. Only a comprehensive program that takes into consideration all the issues will help the patient regain overall health and avoid long-term side effects from dangerous medications.