FIBROMYALGIA

FIBROMYALGIA: What to do?
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What's different about fibromyalgia (aka FM)? What to do if you've got it?

It's a lifelong disorder! One of the major physical abnormalities that occurs with FM lies in the muscle itself, where there's a build up of a protein called “Ground Substance.” Ground substance is normally found in muscle, bone and connective tissue all over the body and is responsible for making the tissues stronger and less susceptible to tearing. In the healthy body, when a muscle is injured the muscle tissue itself is able to regenerate and over time, completely heal itself. In a person with FM, the muscle is unable to completely heal itself. Instead, an abnormally large amount of ground substance builds up in the injured area. It is this ground substance, together with muscle spasm, that creates the muscle ‘knots’ occurring with FM.

A number of tests may be done to rule out other disorders and an examination can reveal whether a person has the characteristic tender areas on the back of the neck, shoulders, sternum, lower back, hips, lower leg (shins), elbows, or knees. Unlike its cousin SLE (aka lupus), there are currently no diagnostic laboratory tests for FM. Because there are no clinical tests for FM, some doctors conclude that a patient's pain is not real, or they may tell them that there is little they can do. However, a combination of naturopathy, trigger point therapy, and lifestyle changes has proven to be very effective in decreasing the severity and duration of the physical pain and disability of FM. It’s important not to ‘overdo’: FM sufferers are quick to notice they feel better when they’ve heated themselves with exercise to the point of sweating — but they don’t connect it with the pain & discomfort that follows over-exercising.

FM is difficult to treat. Not all doctors are familiar with FM and its treatment, so it is important to find a doctor who is. FM treatment often requires a team approach utilizing naturopathic care with trigger point therapy, soft tissue therapy, dietary changes, as well as exercises & stretching.

Naturopathic care is critical for those who suffer from FM in order to keep the body from losing too much movement. Because FM causes the muscles to tighten up and lose some of their natural pliability, it translates to a loss of movement in the spine. The loss of movement in the spine results in a neurological reflex that causes the muscles to tighten even further. This vicious cycle will continue & over time leads to increased pain, increased muscle tightness, loss of movement, more difficulty sleeping and the development of more & more trigger points.

The only option is to continually ‘tune’ the body & keep it moving, yet give it time to respond to treatment. A common treatment regime for FM sufferers is twice a month over an eighteen-month period to keep everything mobile & relaxed. The biggest concern in treating people with FM is that their muscles have a diminished healing ability. For this reason, treatment is modified to be more gentle than normal. This helps to decrease the stress on all of the small supporting muscles of the spine, which can be easily injured. It is important when seeking naturopathic care, to make sure that the doctor is familiar with the muscle changes that occur with FM so that they can adjust treatment accordingly.

The overwhelming characteristic of FM is long-standing body pain with well-defined tender points and frequently, trigger points. Trigger points are often confused with ‘tender’ points. They are not the same: A trigger point needs firm pressure to elicit pain, while tender points (aka "Ah-Shi" or "Personal" Points) are painful to even very light pressure. Trigger points will refer pain to other areas of the body, whereas tender points will not. Unlike tender points, trigger points can occur in isolation & represent a source of radiating pain, even in the absence of direct pressure. As mentioned above, trigger points are purely comprised of muscle fibers in spasm, whereas tender points are knots filled with ground substance. Persons with FM almost always have a combination of the two (trigger points & tender points) and can improve dramatically with light trigger point therapy.

Trigger point therapy for FM is much like trigger point therapy for back pain, neck pain or headaches. The points are the same. The difference is just intensity. Since the muscles in patients with FM are easily injured and take longer to heal, it is necessary to use less pressure on their trigger points.

Daily lifestyle choices you make have a tremendous impact on how much impact FM will have on your life. The difference between those who take care of themselves and those who do not is tremendous. Those who make lifestyle changes to help their FM suffer much less pain, are able to remain more active and have a much better quality of life than those who don’t. If you have FM, here are some of the main things that you can do on a daily basis to help your body:

Getting enough sleep and the right kind of sleep can help ease the pain and fatigue of FM, but is something that can be hard to get. Many FM sufferers have pain, restless leg syndrome and brain-wave irregularities that interfere with restful sleep. Insomnia is very common. Although alcohol may help you to relax, it is not recommended as it has been shown to interfere with restful sleep. Some have found 5-HTP (5-hydroxy tryptophan) very helpful, low-dose melatonin works for some, Methyl B-12 (under-tongue tab) can relieve tiredness and more, as well as neurontin or anti-depressant Elavil (prescription drugs are necessary for some persons). No healing occurs without enough proper sleep. It’s important to remember that best sleep comes in a dark room with no-TV & no-noise.

Improved fitness through exercise is recommended. Studies have shown that FM symptoms can be relieved by aerobic exercise. Though pain and fatigue may make exercise and daily activities difficult, it's crucial to be as physically active as possible. The best way to begin a fitness program is to start with low impact exercises: Tai Chi is highly recommended {ask us: we have an excellent DVD you can do without a trainer}, or just EZ walking, & relaxed swimming. Starting slowly helps stretch and mobilize tight, sore muscles. High-impact aerobics and weight lifting can cause increased discomfort, so pay attention to your body. The more often you exercise, the better off you’ll be. Just an EZ 15-minute daily walk can make a difference. Oh, if your dog pulls on the leash leave the dog at home (that tugging leads to sore muscles!). Remember, over-doing will make you hurt later!

About work: Most people with FM are able to continue working, but they may have to make big changes to do so. It may be necessary to reduce the number of hours at work, find a job that will allow you to have a flexible schedule, or switch to a less physically demanding job. Many people with FM require specially designed office chairs, adjustable desks or other adaptations in order to continue working. If you face obstacles at work, such as an uncomfortable desk chair that leaves your back aching or difficulty lifting heavy boxes or files, your employer may make adaptations that will enable you to keep your job. Remember to walk around your chair every 30 minutes (pumps fresh blood thru muscles). Keep your computer-screen slightly below eye-level & your keyboard just below elbow-level (avoids neck, shoulder, wrist, & eye-strain).

Eating properly is important. Foods can stress your body or help it heal. Foods that tend to be stressful include: dairy, eggs, wheat, corn, as well as anything with monosodium glutamate (MSG), nitrates or nitrites (processed foods). Several environmental toxins may also contribute to stress; so warm-water fish, & red meats should be avoided as well. It’s important that you eat as much clean, organically-grown fresh foods as possible. Build your diet around whole foods such as brown rice, legumes, oats, rice milk, cold-water fish (salmon, halibut, cod, herring, Norwegian sardines, etc., but avoid the large fish), roots, nuts, berries, hormone-free chicken or turkey. Try eating Chinese, Japanese, Indian & Asian foods occasionally.

There are dozens of nutritional products that claim to be the answer for FM. None of them have proven to be of much long-term benefit for anyone. Magnesium malate, ginkgo biloba, & some herbals help some people. 5-HTP may help with pain & sleep. Up to 100mg/day seems ok. 5-HTP should NOT be used if taking: MAO Inhibitors, anti-depressants, serotonin inhibitors (Prozac, etc), wt. loss meds, L-dopa (or other Parkinson's meds), tranquilizers, anti-histamines or cold meds, alcohol in any form, chemotherapy, antibiotics.

The bottom line with nutritional supplements is that nothing works for everyone. If you come across something that you would like to try, by all means do so carefully; check it out with your naturopath first to ensure that it won’t interfere with your treatment.

With your cooperation, your fibromyalgia can be controlled!
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No one believing you have FM? — Or that FM even exists?
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WE BELIEVE YOU!
THERE IS FM & THERE IS HELP.
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