Conditions

Fibromyalgia

Fibromyalgia is a rheumatic disorder characterized by chronic achy muscular pain that has no obvious physical cause.

Signs and Symptoms:

• Stiff, aching muscles
• Burning or throbbing pain
• Tender points at certain areas of the body

The areas most often effected by fibromyalgia are:

• Base of the skull
• Base of the neck
• Upper back
• Mid-back
• Second rib
• Side of the elbow
• The upper and outer muscles of the buttocks
• The upper part of the thigh
• Middle of the knee

Diagnosis:

• A careful patient history should be taken that focuses on the timing and the conditions surrounding the presentation of symptoms, and a physical examination should be performed to exclude other disorders.
• Laboratory tests are useful only to exclude other disorders.
• Radiographs, blood tests, and a physical examination of the joints should be performed to show that there are no abnormalities. A patient is classified as having FMS if there is a history of the symptoms listed below.
• Widespread pain for at least three months
• Pain reproduced by digital palpation of tender points
• Persistent fatigue
• Generalized morning stiffness
• Nonrestorative sleep disturbance (patients often complain of being tired upon awakening)

Treatment Options:

There is no single treatment protocol because of the variable patient presentations. The goal of treatment is simply to maximize functional status. The nonsteroidal anti-inflammatory drugs and salicylates do not provide complete or long-lasting pain relief, though they may transiently reduce pain in some patients during flare-ups. Because FMS is not an inflammatory condition, glucocorticoids are ineffective. Narcotics may work initially but should only be used for intense flare-ups and for short periods.

Traditional Treatments:

• Before any treatment is tried for fibromyalgia, your doctor will want to make sure there is no other explanation for your symptoms.
• In some cases, people with fibromyalgia get better on their own, without any kind of treatment. Anxiety and stress are believed to play a part in this condition and are known to exacerbate symptoms.
• Over-the-counter pain medications are not helpful in the majority of the cases, but some people find they give relief.
• Gentle massage, heat therapy, moderate exercise and additional sleep may also be helpful.
• Some doctors prescribe low doses of an antidepressant such as amitriptyline (Elavil) or nortriptyline (Aventyl, Pamelor) for people with fibromyalgia. The lower the dose used, the better, as these drugs can cause side effects.

Complementary and Alternative Therapies:

Nutritional support, herbs, and mind-body techniques may be particularly helpful in reducing symptoms of fibromyalgia and minimizing exacerbations.

Nutritional Supplementation:

• Coenzyme Q10 improves oxygenation of tissues, enhances the effectiveness of the immune system, and works to protects the heart.
• Coenzyme A works with Coenzyme Q10 to increase energy supply to the cells.
• Lecithin promotes energy, enhances immunity, aids in brain function, and improves circulation. Follow label directions.
• Malic acid and magnesium are involved in energy production in many cells of the body, including the muscle cells. Follow the label directions.
• Proteolytic enzymes reduce inflammation and improve absorption of foods, especially protein, which is needed in tissue repair. Follow label directions.
• Antioxidants help reduce free-radical damage and fight inflammation. Take a good antioxidant formula that provides 5,000 to 10,000 IU of vitamin A; 400 to 800 IU of vitamin E; up to 10,000 mg of buffered vitamin C; and 200 mcg of selenium daily.
  Warning: If you are pregnant, intend to get pregnant, or if you have liver disease, consult your doctor before taking supplemental A. If you have high blood pressure, limit your intake of supplemental vitamin E to a total of 400 IU daily, and if you are taking blood thinners, consult your physician before taking supplemental vitamin E.
• Bromelain helps reduce inflammation. Take 400 mg three times daily, between meals.
• Lipoic acid is very useful for enhancing the body's utilization of carbohydrates and enhancing energy. Take 100 mg three times daily.
• Nicotinamide adenine dinucleotide hydrogen (NADH) is an antioxidant enzyme that occurs in all living cells. Take 15 mg one-half hour before breakfast and dinner, often improves concentration, stamina, and energy.
• Phosphatidylserine, a type of lipid, can be helpful if memory problems accompany fibromyalgia. Take 75 to 100 mg three times daily.
• S-adenosylmethionine (SAM or SAM-e) is an amino acid derivative that has been shown to reduce the number of trigger points and areas of pain. Take 400 mg two or three times daily. Can take up to 6 weeks to see results.

Alternative Therapies:

• Pine-bark and grape-seed extracts are natural anti-inflammatories that help to ease pain. Take 50 mg of either two to three times daily.
• St. John's wort has both antiviral and antidepressant properties. If you are not taking a conventional antidepressant and your mood is not what it should be, this herb can help. Chose a standardized extract containing 0.3 percent hypericin and take 300 mg three times daily.
• Siberian ginseng may be beneficial for fibromyalgia. Take 100 mg twice daily, one-half hour before breakfast and lunch. After two weeks, you can gradually increase the dosage as needed. After six weeks, take one week off, then take the herb for another six weeks.
• Turmeric contains curcumin, which helps to reduce pain and inflammation. Take 400 to 500 mg three times daily.
• Black walnut and garlic can aid in removing parasites.
• Calendula or rosemary oil (or a combination of the two), diluted with an equal amount of water or vegetable oil and massaged into the skin, helps to relieve pain.
• Topical applications of cayenne powder mixed with wintergreen oil can help relieve muscle pain. Use 1 part cayenne powder to 3 parts wintergreen oil.
• Put 4 to 6 ounces of ginger powder into a moderately hot bath. This will induce sweating and help remove toxins. Drinking hot ginger tea will have the same effect.
• Ginkgo biloba improves circulation and brain function.
• Kava kava decreases anxiety and elevates the mood.
• Skullcap and valerian root improve sleep.

General Recommendations:

• Include pomegranates and pomegranate juice in your diet. They have anti-inflammatory and antioxidant properties.
• Eat four or five small meals daily to keep a steady supply of protein and carbohydrates available for proper muscle function.
• Limit your consumption of green peppers, eggplant, tomatoes, and white potatoes. These foods contain solanine, which interferes with enzymes in the muscles, and may cause pain and discomfort.
• Limit your intake of saturated fats.
• Avoid wheat and brewer's yeast until your symptoms improve.
• Use wheatgrass retention enemas to detoxify the system. To make the enema, add 1oz. of wheatgrass juice to 1 cup of warm water.
• Use this treatment every other day for two weeks.
• Maintain a regular program of moderate exercise.
• Be sure to get sufficient rest.
• Consider trying massage therapy.
• Have your doctor check your thyroid function.
• Consult a homeopathic practitioner for a constitutional remedy.
• Take a hot shower or bath to relieve morning stiffness.

Warnings:

• If you are pregnant, intend to get pregnant, or if you have liver disease, consult your doctor before taking supplemental A.
• If you have high blood pressure, limit your intake of supplemental vitamin E to a total of 400 IU daily.
• If you are taking blood thinners, consult your physician before taking supplemental vitamin E.