Fibromyalgia: an approach on resolving

Abstract

Fibromyalgia has a doom and gloom outlook that is not curable by western means. This is in part because pharmaceutical drugs can not give peace to the troubles of the mind, a purpose to live, or life beyond this earth. In this argument for the cure for fibromyalgia and not a drug to mask it, I will discuss western approaches with their success rates along with an integrated approach and the success rate outlook.  The body, mind and spirit are vital for healing fibromyalgia.  Because the pain is physical, yet in most cases stems from lifelong chronic stress and emotional pain, it is important to look at underlying causes.The 3 factor approach I will discuss in resolving fibromyalgia include  acupuncture, food therapy, and meditation.  Case studies show the effects of integrated medicine to alleviate fibromyalgia pain.  How much a person feels better relies heavily on the desire and compliance of the fibromyalgia patient.  Underlying basic signs of fibromyalgia can be unlayered and treated for complete healing. 

The Problem

A patient goes to their doctor with complaints of fatigue, no motivation and systemic pain.  Doctors perform blood work to rule out conditions such as rheumatoid arthritis. These tests include Erythrocyte sedimentation rate, C-reactive protein, Rheumatoid factor, full blood count, ccp antibodies, and antinuclear antibody. Many tests come back normal and the patient gets the “good news that they are ok”.   So many side effects to an underactive hypothalamus and hormonal responses due to chronic sympathetic responses.  Low functioning hypothalamus can show signs of fatigue, weakness, headache, high or low blood pressure and body temperature changes. The hypothalamus links the nervous system to the endocrine system which keeps our body in rhythm ( Kong, 2021.) Under acting hypothalamus has symptoms similar to fibromyalgia.  And without a direction in healing for this patient, they feel it is all in their head, ashamed, and the cycle of pain and fatigue continues.  Patients could have a virus, lyme disease, joint pain, and sleep apnea, which could all show signs of fibromyalgia. Friends and family talk behind their backs that they are a hypochondriac or faking.    Medically no  pathology can be found to explain ongoing pain and disability. Welcome to the world of fibromyalgia.

A little Background and Symptoms of Fibromyalgia 

Once called fibrositis in the late 1800’s, this debilitating chronic problem now affects 1 in 20 people.  That is over 8 million people coming out with a diagnosis of fibromyalgia. According to the Center for Disease and Control, symptoms of fibromyalgia include pain all over, fatigue, anxiety, lack of sleep, concentration, headaches, digestion disorders and numbness in the hands and feet.

Comparing Fibromyalgia and Anxiety

According to The Science of Fibromyalgia, (Claw, 2011) not including an underdiagnosis of patients up to 75%, still 2-5% of the population suffers from fibromyalgia.  Transversely,  the World Health Order states 5% of the population suffers from anxiety. Chronic anxiety are closely aligned with fibromyalgia with symptoms including pain, fatigue, not being able to fall asleep, not able to stay asleep, digestive issues and headaches. 

Western treatment for patients with Fibromyalgia

Western approach to fibromyalgia is classified in the rheumatoid arthritis category. Nerve studies are found to be inconclusive to pain. In the review, Chronic Opiod Use in Fibromyalgia Syndrome, conclusions are made in the case to limit or cease the amount of chronic opioid use. (Painter, 2013) Other treatments include pain blockers, steroids, sleep medication to anticonvulsants. Treatment for fibromyalgia uses medications that block receptors in healing and have side effects that can cause more pain and more symptoms.  Drugs administered are touted for patients to use forever as there is no cure.  

Eastern medicine philosophy and approach to Fibromyalgia

The rise of pain from unknown causes and autoimmune is exponentially growing. 

Chinese medicine looks at fibromyalgia as a deficiency in qi. Many individual factors can direct which qi and pathway is blocked or deficient. Case study with fibromyalgia show acupuncture had substantial benefits over other modalities. “ The number of tender points was significantly decreased after acupuncture treatment, compared to no treatment (p > 0.05)” (Cao, 2010)

Natural science based healers are breaking ground with case studies and research leaning to hypothalamus fatigue and hormonal fatigue. 

How the autonomic nervous system is overused with those suffering with Fibromyalgia

The autonomic nervous system works with a sympathetic parasympathetic relationship.  Sympathetic is fight or flight and parasympathetic is rest and digest.   The sympathetic nervous system was perfectly designed from the hypothalamus to send hormones like epinephrine into the bloodstream. Symptoms of chronic sympathetic nervous system working includes increased heart rate, fatigue, dilated muscles and slowing of digestion. With continuous stress, anxiety and depression, the activation of the sympathetic nervous system is nonstop. Many years of worrying and anxiety has exhausted the autonomic nervous system.   

Cases where fibromyalgia was resolved

In a case study, Fibromyalgia Syndrome: A Case Report on Controlled Remission of Symptoms by a Dietary Strategy, a 34 year old woman experienced fatigue, irritable bowel, leg cramps forgetfulness, depression and chronic pain. Rheumatoid was ruled out by blood work.  The plan was to boost serotonin levels by upping the absorption of tryptophan. The female avoided fructose and sorbitol. Remission of most symptoms was reached in 2 months. (Lattanzio, 2018)

Ways fibromyalgia can be resolved with an integrated Approach 

When we look at fibromyalgia stemming from a chronic sympathetic nervous system reaction, we have to be careful how to relay that to a patient.  Even though many self describe themselves as a worrier, if told the painful condition comes from being a worrier, anxiety or stress in their life, they may get defensive.   If the patient goes to their families and friends with the reasons for their fibromyalgia, they may constantly remind them how they worry or stress.  Wording when treating fibromyalgia is important for the patient’s strength to successfully heal.  Possible verbiage for the patient could be hypothalmus deficiency, or adrenal fatigue.

To resolve fibromyalgia 3 things should be utilized: Food therapy, acupuncture and meditation. Treating a fibromyalgia patient with herbals and food therapy is an important way to get nutrients needed to nourish hormone levels, and to provide nutrients to lessen pain and for better sleep. To create a strong gut biome, food therapy includes fermented foods like sauerkraut, nutritional yeast, miso, kombucha, apple cider vinegar and kimchi. Gut biome and fibromyalgia pain levels were decreased using supplements of vitamin C, vitamin E, chlorella, and coenzyme Q10 due to oxidated stress. Levels of energy were increased. (Lowry, 2020) In Nanjing University Hospital, fibromyalgia is treated primarily with herbal medicine and only secondarily with acupuncture. (Mist, 2010)  According to Nanjing University Hospital practitioners, the primary formula is xiao yao san, the wanderer.  Single herbs include hypericum (Guan Ye Lian Qiao) for depression, American ginseng (Xi Yang Shen) for lethargy and valerian root (Xie Cao) for insomnia. (Mist, 2010)

Acupuncture is thousands of years strong for pain. Fibromyalgia in traditional Chinese medicine is called “Jin bi” which means “Bi syndrome.”  Fibromyalgia stems from a qi deficiency and stagnation of qi and blood.  A random control trial performed on 75 women with fibromyalgia with 2 acupuncture treatments a week for 4 weeks. This study showed a profound rise in serotonin that lasted after the 8 week recheck. ( Karatay, 2018) Acupuncture points should focus on the movement of qi and blood. Ren 4 and Ren 6 are together called dantian, where the deepest of energy is stored. Main qi deficiency points include gallbladder 21, bladder 13, spleen 6, lung 9, stomach 36, liver 3, large intestine 4,spleen 3, spleen 10 to move blood. Along with these points to consider, ashi points along the meridian should be addressed. The amazing thing about acupuncture is that it gets the body moving. Acupuncture makes a micro trauma that brings a reaction to the body in order to heal.

Meditation is the most undervalued form of healing in our world. Diminished as folklore and anecdotal, a study with the US Department of Veterans Affairs called Mindfulness Meditation Alleviates Fibromyalgia Symptoms in Women: Results of a Randomized Clinical Trial (Behav, 2015) shows a significant decrease in sympathetic reaction when meditation was used 4 times a week for 45 minutes.  Physically, meditation is increasing lung capacity. When we are stressed or anxious, we take shallow breaths. Patients usually when questioned in stressful situations, take a big inhale, a clear indicator of compromised lung capacity. Chronic emotional struggles can lead to deficient lung capacity and improper use of the diaphragm.  Brain damage begins after 4 minutes with lack of oxygen.  An important read in understanding the physical effects of limited oxygen or hypoxia was an article Skeletal Muscle Fiber Type in Hypoxia: Adaptation to High-Altitude Exposure and Under Conditions of Pathological Hypoxia. (  )  At the “and under conditions of pathological hypoxia” is exactly what fibromyalgia is.  The relaxed deep breathing are bodies need to survive are limited to short bursts and sighs.  To restate sympathetic and parasympathetic it is rest (breathe) and digest, or fight and flight. Chronic emotionally strained patients are not focused on the most basic principle for life. Breathing. Meditation is just one easy way to provide basic life to our body.

Biography

Mary Devereaux is originally from Warwick Rhode Island and resides in Florida. Her undergraduate degree was focused on physics and wellness.  After years working in the health industry, she found traditional Chinese medicine met her needs as a practitioner.  Her focus on emotional pain leading to chronic pain brought her to specialize in fibromyalgia and rheumatoid arthritis. Mary graduated from the Florida College of Integrated Medicine. She is licensed to practice in Florida and works in an integrated physicians group where practitioners can work together to provide the best care for patients.  She is board certified in acupuncture and herbology. She is a member of NCCAOM and FCOM. She is looking to hold a doctorate of acupuncture and oriental medicine in the summer of 2022 from the Pacific College of Health and Science. 

References

Ann Behav Med. 2015 June ; 49(3): 319–330. doi:10.1007/s12160-014-9665-0, US Vetereans Affair

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Chaillou, Thomas. “Skeletal Muscle Fiber Type in Hypoxia: Adaptation to High-Altitude Exposure and under Conditions of Pathological Hypoxia.” Frontiers, Frontiers, 1 Jan. 1AD, https://www.frontiersin.org/articles/10.3389/fphys.2018.01450/full.

Clauw, D. J., Arnold, L. M., McCarberg, B. H., & FibroCollaborative (2011). The science of fibromyalgia. Mayo Clinic proceedings, 86(9), 907–911. https://doi.org/10.4065/mcp.2011.0206

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Karatay, S., Okur, S. C., Uzkeser, H., Yildirim, K., & Akcay, F. (2018). Effects of Acupuncture Treatment on Fibromyalgia Symptoms, Serotonin, and Substance P Levels: A Randomized Sham and Placebo-Controlled Clinical Trial. Pain medicine (Malden, Mass.), 19(3), 615–628. https://doi.org/10.1093/pm/pnx263

Kong, J., Huang, Y., Liu, J. et al. Altered functional connectivity between hypothalamus and limbic system in fibromyalgia. Mol Brain 14, 17 (2021). https://doi.org/10.1186/s13041-020-00705-2

Kozasa, E. H., Tanaka, L. H., Monson, C., Little, S., Leao, F. C., & Peres, M. P. (2012). The effects of meditation-based interventions on the treatment of fibromyalgia. Current pain and headache reports, 16(5), 383–387. https://doi.org/10.1007/s11916-012-0285-8

Lowry, E., Marley, J., McVeigh, J. G., McSorley, E., Allsopp, P., & Kerr, D. (2020). Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis. Nutrients, 12(9), 2664. https://doi.org/10.3390/nu12092664

https://www.who.int/health-topics/depression#tab=tab_1

Mist, S., Wright, C., Jones, K. D., Carson, J. W., & Shih, J. (2010). Traditional Chinese Medicine for Fibromyalgia. Practical pain management, 10(7), http://www.practicalpainmanagement.com/pain/myofascial/fibromyalgia/traditional-chinese-medicine-fibromyalgia. 

Painter, J. T., & Crofford, L. J. (2013). Chronic opioid use in fibromyalgia syndrome: a clinical review. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 19(2), 72–77. https://doi.org/10.1097/RHU.0b013e3182863447

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