An Integrative Approach to Fibromyalgia

An Integrative Approach to Fibromyalgia

By Robert A. Weissberg, M.D.

Integrative Medicine

An optimal understanding and treatment of chronic Fibromyalgia or Fibrositis, requires a whole-person multidisciplinary approach. This type of pain sometimes follows an injury, the injured tissues appear to heal, but the pain remains and spreads. Sometimes, Fibromyalgia starts without an obvious physical trigger. There are often specific tender spots in many different locations, and some of these, when pressed, lead to pain radiating to other parts of the body. There is often a disturbance of sleep, and there is sometimes associated emotional depression, fatigue, and irritable bowel symptoms.

The usual medical model of finding one cause and one treatment fails miserably with Fibromyalgia. Once the other connective tissue diseases and sources of pain have been considered and ruled out, we are left with the distressing complex of problems presented here. Here is an Integrative approach.

Using a Functional Medicine model, we consider the antecedents, triggers and mediators. What events and conditions preceded the problem? What injuries in childhood or later, what emotional traumas? What is the diet? Does/did the person exercise regularly? Are there other people in the family with similar problems? What are the chronic or recent stresses? What about other illnesses that involve pain or stiffness? What was going on in the personÕs life during the time leading up to the onset? What was the nature of the injury? How does this person view the injury or circumstances? Was there some other inflammation going on at the time of onset? What systems are involved in mediating the problem? The musculoskeletal system is the focus, but we also need to consider the nervous system, which allows us to experience and suffer from pain, and the digestive system, which contains more neurotransmitters than the brain, and 60% of the immune cells of the body.

In considering the diet, for example, what are the fatty acids and proteins, and how much sugar is consumed? The chemicals in the body that mediate inflammation and pain are made from fatty acids which we ingest or make in our bodies. If we eat more of the fats which promote inflammation than those which suppress it, we will be more inflamed and in pain, no matter what the stimulus. Similarly, animal proteins and sugar promote the excitatory, Òfight or flightÓ chemicals, whereas many vegetable proteins promote the restorative balancing chemicals in the nervous system. It is also possible, especially if our systems are Òcranked upÓ by stress or diet, to become ÒallergicÓ to many common foods. Sometimes, these foods can induce inflammatory responses, such as joint and muscle pain, or just add to the overall inflammatory pricture. If our intestinal tracts are not working properly, we can develop Òleaky gutÓ and overgrowth of certain bacteria and yeasts, which make it easier for us to become food-sensitive, and also enables us to absorb more inflammatory substances, or toxins. Changes in the diet in an anti-inflammatory direction, elimination of foods to which we are sensitive, and taking steps to heal the intestinal tract can make major improvements. Further help can be obtained from supplements of anti-inflammatory fatty acids, vitamins and herbs, as well as those which promote detoxification.

The hormonal system is very important to consider in fibromyalgia, especially when there has been much stress involved. The adrenal glands secrete our stress management hormones, such as adrenalin and cortisol, which regulate many body functions and also energy metabolism. Insulin enables us to utilize glucose in out tissues, and to store excess energy as fat. It is also closely involved in promoting, while cortisol modulates inflammation. Chronic stress can get these hormones out of balance, leading to chronic fatigue, insulin resistance, weight gain, increased pain and inflammation, elevated blood pressure, and many other related problems. Management of stress, limiting carbohydrates and saturated fats, weight loss, exercise, and supplements to promote healing of the adrenals and reduction of insulin resistance are very useful.

Another important area to look at is energy and circulation. Along with physical bodies, we all have energy bodies. In conditions such as Fibromyalgia, the energy flow can become blocked or stagnant, which eventually corresponds to poor tissue fluid drainage and circulation. Work at the energy level, with acupuncture, acupressure, Reiki, Healing or Therapeutic Touch, JinShinDo and similar methods can be extremely useful. Therapeutic massage, which treats the physical and energy systems, is well known to alleviate the stiffness, and promote circulation, as well as allowing for release of trigger points and areas of chronic spasm. Numerous studies have shown benefits with fibromyalgia.

Finally, Mind-Body approaches are critical in working with fibromyalgia. Regular meditation is an excellent proven method of self-help, leading to muscle relaxation, improved circulation, sleep, and stress management. In addition, autohypnosis, guided imagery and certain types of stress-management training and psychotherapy are often useful.