Fibromyalgia

[Guest guest]

I just received this and wanted to share it with you since we have a lot of

people on this list who have this problem.

Christel

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Welcome to the Healing Center for Fibromyalgia.

I am Edelberg, M.D.

http://www.americanwholehealth.com/library/fibromyalgia/fmsalt.htm

If the muscles in your upper back and neck ache all the time for

inexplicable reasons, it's possible you have fibromyalgia. Virtually every

day, patients (mainly women) come into the office with what turns out to be

this condition. Either they describe long-standing symptoms associated with

fibromyalgia, or they're aware of their diagnosis but were told by their

doctors that nothing could be done to help them.

While at present no doctor, including me, can cure fibromyalgia, there is

plenty we can do to help you feel better. In fact, our integrated approach,

using conventional medicines, supplements, and other measures we recommend

at WholeHealthMD, has produced real benefits for hundreds of my patients.

What is Fibromyalgia?

Fibromyalgia is a common but poorly understood disorder characterized by

chronic muscle pain, nonrestorative sleep, and profound fatigue. Although

fibromyalgia symptoms may imitate an autoimmune disease like rheumatoid

arthritis, blood tests rarely come back positive and joint changes almost

never develop. In fact, although symptoms can worsen over time, fibromyalgia

rarely progresses to anything that could be officially categorized as

" life-threatening " (although sometimes long-term disability can occur).

Even after what may appear to be a good night's sleep, a person with

fibromyalgia frequently wakes up feeling fatigued and experiencing muscle

aches or stabbing pains, which may ease during the course of the day.

Symptoms may be constant, or they may subside for months at a time, only to

return. Diagnosing fibromyalgia can be difficult unless your physician is

specifically looking for it. Blood tests and X rays do not detect it, and

its symptoms can be very similar to those of other disorders, particularly

chronic fatigue syndrome, rheumatoid arthritis, osteoarthritis, and

depression.

To distinguish fibromyalgia from other conditions, a doctor will apply

pressure to 18 specific body sites, called tender points, mainly areas where

fibrous tissues tie muscles to bones. These points are located at the base

of the skull and on the neck, shoulders, ribs, upper chest (near the

collarbone), elbows, knees, lower back, and buttocks. Light pressure on a

tender point can cause a person with fibromyalgia to cry out or flinch in

pain.

As the physician is applying pressure to the tender points, it is very

helpful if the patient appreciates the same amount of pressure applied to a

spot usually free of tender points (like the front of the thigh). Patients

are often surprised at the contrast between a " neutral point " and a " tender

point. " A diagnosis of fibromyalgia is made when muscle pain and fatigue

last for three months, other possible causes have been ruled out, sleep is

unrefreshing, and the patient reports pain to fingertip pressure at least 11

of the 18 tender points.

Fibromyalgia affects women more often than men, especially women between the

ages of 20 and 50. Although fibromyalgia sometimes appears to be triggered

by physical trauma, such as whiplash, longstanding chronic emotional stress

seems to predispose many people to developing this condition. In fact,

fibromyalgia often appears to be a change the body undergoes in response to

chronic stress, much like irritable bowel syndrome or migraine headaches. In

all these conditions, physical symptoms are very real and often quite

incapacitating. Consider, for instance, how unconsciously most people " tense

up " their muscles when stressed. Now imagine tensing up day in and day out,

and you set the stage for developing fibromyalgia.

Like chronic fatigue syndrome, fibromyalgia can involve a dizzying array of

symptoms, presenting researchers with many avenues for investigation.

Although studies to find possible causes and treatments are ongoing, in the

meantime there are many ways to help patients with fibromyalgia feel

healthier.

Key Symptoms

Chronic and widespread muscle aches, pain, and stiffness (usually at their

worst in the morning) present for at least three months

Extreme sensitivity to pressure in at least 11 of 18 specific tender points

on the body

Chronic or occasional deep fatigue, even after adequate sleep

Unrefreshing or poor-quality, non-dreaming sleep

Depression, often accompanied by anxiety

Headaches

Difficulty with concentration or performing once simple mental tasks

Impaired muscle coordination

What Causes Fibromyalgia?

Although the exact cause of fibromyalgia is unknown, some scientists

attribute the disorder to low levels of serotonin, a chemical that relays

messages throughout the brain and nervous system. The lack of serotonin may

either cause muscle pain directly or aggravate it by disturbing sleep

patterns.

Another possible cause may be an excess of substance P, which is thought to

play a role in the transmittal of pain messages from the body to the brain.

Very high levels of substance P may lead to the abnormal sensitivity to

pain-producing stimuli in people with fibromyalgia.

Genetics may also play a role because some people are simply born with a

tendency to develop blood clots more easily, which seems to decrease

circulation to the muscles.

Other factors that seem to trigger or are somehow associated with the

disorder include:

An especially severe case of the flu

A physical injury such as whiplash

An impaired immune system

Emotional stress and depression

Lack of exercise, poor physical fitness, and impaired circulation

Chronic fatigue syndrome (the two disorders may occur together).

Treatment and Prevention

Maintaining physical fitness through regular exercise and good nutrition can

reduce your risk of developing fibromyalgia, but there is no known way to

prevent it. Once the disorder occurs, the aim of treatment is to relieve

pain and stress and promote deep sleep and relaxation.

A physician will probably recommend over-the-counter pain relievers and

prescription medications to induce restful sleep and reduce pain. But

nutritional supplements that relax muscles and raise serotonin levels,

combined with regular aerobic exercise, massage, and relaxation techniques,

can help control the symptoms of fibromyalgia.

For many patients, the real breakthrough in their fibromyalgia occurs when

they appreciate the connection of their symptoms to longstanding stress. For

example, the discovery that the fibromyalgia pain dramatically lessens

during an extended vacation, or a change in jobs can be eye-opening.

Treatment is then less focused on taking medicines to control pain and more

on making whatever lifestyle changes may be in order.

Just a reminder: If you have a serious medical condition, it's always a good

idea to talk to your doctor before beginning a program of supplements.

How Supplements Can Help

People with fibromyalgia are often lacking in the mineral magnesium. Taken

in combination with malic acid, this mineral helps fight fatigue and relax

muscles. (Malic acid also enhances magnesium absorption.) Magnesium and

malic acid supplements, sometimes sold in a combination product as magnesium

malate, are highly recommended for anyone with fibromyalgia. Allow at least

two months for results to begin to appear.

Both the herb St. 's wort and the nutritional supplement 5-HTP

(5-hydroxytryptophan, a form of the amino acid tryptophan) increase

serotonin levels, help ease depression, and improve tolerance to pain.

Consider taking either supplement along with magnesium and malic acid.

(However, unless your doctor recommends it, do not take St. 's wort or

5-HTP if you're taking prescription antidepressants.)

Grape seed extract is a powerful antioxidant, which you can take to help

prevent muscle cell damage.

If you also have a significant component of fatigue with your fibromyalgia,

coenzyme Q10 (coQ10) and NADH may be helpful to relieve the symptoms. Each

of these is involved in maintaining the mitochondria, the energy producing

unit of the cell. A recent study from the University of Texas found NADH

very helpful in reducing the fatigue of fibromyalgia.

Melatonin or the herb valerian can help you get to sleep more easily.

If stress is a significant factor in the flare-ups of fibromyalgia, the herb

kava is a safe, nonsedating, non-habit-forming natural tranquilizer.

Recently available in the United States, the amino acid SAMe, widely used by

European doctors for depression and arthritis, has been showing promise in

the treatment of fibromyalgia.

In addition, most people with fibromyalgia seem to have low levels of DHEA,

(dehydrepiandrosterone) a key hormone secreted by the adrenal glands.

Supplements can help redress this deficiency; however, most experts feel

this should be done under the direction of a physician.

Get supplement dosages and tips in our WholeHealthMD Supplement

Recommendations for Fibromyalgia.

Self-Care Remedies

Over-the-counter pain relievers can provide some relief from pain and

stiffness. But don't take them regularly on a long-term basis without

talking to your doctor. For severe fibromyalgia pain, the best prescription

medications seem to be Flexeril (cyclobenzaprine) a muscle relaxant, and

Vicodin (oxycodone) a painkiller derived from codeine.

To relieve pain and stiffness and increase circulation, soak in a hot bath

or apply a heating pad. Just before going to bed, soak in a hot bath to

which you've added 1/2 cup of epsom salts. While still warm from the bath,

go immediately to bed. Having the bed prewarmed with an electric blanket may

allow a restful sleep and less pain on arising. On those days you awaken

with a lot of discomfort, go immediately to a hot bath or shower.

An S-shaped " back knobber " is an extremely useful tool with which you can

self massage the difficult-to-reach tender points of your neck, shoulders,

and upper back.

Administered regularly by a trained professional familiar with fibromyalgia,

massage (particularly a technique known as myofascial trigger point therapy)

can be a highly effective pain reliever.

Begin a slow but regularly increasing program of aerobic exercise. Instead

of taxing already sore muscles, aerobic exercise seems to help ease the

symptoms of fibromyalgia. If you haven't been exercising, consult your

doctor first, then start slowly with low-impact activities such as walking,

swimming, or bicycling. Be very careful not to overtax yourself with

exercise or you'll experience a real worsening of symptoms the following

day.

If practiced consistently under the supervision of trained practitioners,

mind-body techniques, such as meditation, movement therapy, and biofeedback,

can help relieve muscle tension and stress.

For proper muscle function, your body needs protein and carbohydrates

throughout the day. To maintain a steady supply, eat several small meals

during the day instead of three large ones.

Cut back on alcohol, caffeine, and sugar, all of which cause fatigue.

Try to get at least eight hours of sleep at night. A firm mattress may

minimize nocturnal muscle pain and help you sleep better.

Healthful eating may help decrease a person's risk. A good diet is less

stressful on the body than one with lots of junk food.

When to Call a Doctor

If you experience the symptoms of fibromyalgia for three months. (Call your

doctor sooner if the condition keeps you from carrying out your day-to-day

activities.)

If you have severe difficulty sleeping

If you are depressed

If you have chronic muscle pain and other causes of your symptoms, such as

flu or arthritis, have been eliminated as diagnostic possibilities.

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