See your doctor, this information is educational. This is intended to complement conventional medicine, not to replace it.
What is fibromyalgia? There has been much confusion about this condition in part  because it has been given many names. It used to be called fibrositis, or myofascial  pain, myofascial pain syndrome, psychogenic rheumatism, fibromyositis,  myofasciitis, tensionmyalgia, or psychological muscle disorder.
Chronic muscular pain is just one facet of this syndrome; it runs much deeper than  just sore and aching muscles or joints. Just living with gravity and our modern day  stress can cause much of the soreness and muscle tension that most people  experience. However, when we have the condition of fibromyalgia, or myofascial  pain syndrome, all of the stress and tension is intensified ten-fold.
The chronic pain can be regional, myofascial pain syndrome (in the connective  tissue or muscles) or widespread fibromyalgia with overall aches and pains  accompanied by neurological and other problems. The condition can be very severe  and has many faces.
Since mostly women suffer from fibromyalgia, most experts think it is connected to  the hormone estrogen. It could be an estrogen insufficiency or certain hormonal  changes that affect the muscle pain. It?s usually found in women over thirty.
I have never heard of males with this condition in my thirty years of experience. I  have known only a few women that actually were diagnosed with this condition.
The pain of fibromyalgia is different in every individual and has no limits;  sometimes it?s a dull pain and other times sharp. It can be numbness on the  surface of the skin or deep, muscular aching that is dull, shooting, burning,  throbbing or stabbing, sharp pain. Most often, the pain and stiffness are worse in  the morning, and it?s not unusual to hurt in the muscle groups that are used more  often: upper neck, shoulders, low back, hips, and legs. In fact, often every joint may  hurt. Here again it varies with the person. Their activities or jobs, as well as their  mechanical postures, can dictate where they will suffer most.
The Chronic fatigue has been described as ?feeling unmotivated? or ?having mental  fatigue.? Some patients told me if they could get the strength to get out of bed then  they could deal with the rest of the day.
Chronic Headaches Recurrent migraine or tension type headaches are seen in about  50-60% of fibromyalgia patients and can pose a major problem. Just dealing with  the daily activities of life can be a struggle for these patients.
Most have a sleep disorder called the alpha-EEG anomaly. This means that they  don?t get to the deeper levels of sleep and they are constantly interrupted by  awakening brain activity. Thus, when they wake up they feel that they didn?t get any  rest and the body did not get a chance to recover. This condition creates added  stress, which keeps them in the vicious cycle. One of my patients said she felt like  she?d been run over by a truck when she got up every morning. Another one is  Myoclonus or PLMS (nighttime jerking of the arms and legs), restless leg syndrome,  and bruxism (teeth grinding).
Temperomandibular Joint Dysfunction Syndrome (TMJ) is connected with the  headaches or face pain in 25-30% of FMS patients. Research indicates that  as many as 90% of fibromyalgia patients may have jaw and facial tenderness that  could produce the same symptoms of TMJ.
Irritable Bowel Syndrome (IBS) It?s common for many of these women to have bowel  problems, constipation or diarrhea. Frequent abdominal or chest pain is also not  uncommon. These symptoms are found in 60% to 70% of fibromyalgia patients,  according to the research, in addition to PMS and painful menstrual periods  (dysmenorrhea).
Other common symptoms include muscle numbness and or tingling sensations;  muscle twitching; swollen extremities, dry skin or skin sensitivity, dry eyes and  mouth; dizziness and impaired coordination. Often patients experience sensitivity to  weather or wind, rain, and changes in temperature. Hormonal fluctuations  (premenstrual and menopausal states), depression, anxiety and overexertion can all  contribute to symptom flare-ups.
The holistic approach seeks to approach the problem on all levels-- mental,  nutritional, and physical. Each aspect of these problems needs a specific modality or  therapy. We recommend the use of conventional medicine with nutritional, herbal,  biochemical nutrients, bio-mechanical body therapy, and mind-body methods  designed to enhance the body?s own natural healing systems.
We know that the best way to approach a vague disease is to use conventional  holistic practices such as good nutrition, lower fat intake (especially the saturated  fats), less sugar and fewer junk foods. Increase water intake for flushing the system  and increase intake of anti-oxidants Vitamins C, E, beta carotene, and a good multi- vitamin, with increased doses of cell salts and selenium. Some medical experts say  phosphatigylserine, which is a lipid (fat processor) and gingko biloba can also help  ease the condition. Also, adding fish oil capsules.
From a natural perspective, GABA itself is available from the health food stores over  the counter. Again, I just want to caution anyone self-medicating, even with natural  substances.
Magnesium-calcium and selenium supplements also may help by acting on some of  the same neural and muscle receptor sites that GABA influences.
About 80% of our chronic pain patients are deficient in magnesium. That?s because  physical pain (and also mental anguish) cause the muscles to overwork and the  muscles use up much more magnesium than normal. This is a reason why many  athletes need extra magnesium as well.
Ironically, the muscles really need that magnesium to function and not having  enough of it increases muscle spasm and pain, as well as the general vulnerability to  stressful stimuli such as loud noises, chemicals, and emotional distress. So this  hyper-sensitivity puts people in that kind of vicious cycle.
Many of these patients have hypoglycemia or blood sugar control problems as well.  This is normally due to the stress of their illness on the glucose/insulin system.  Excess stress causes the body to be on high alert. Consequently, the dietary  guidelines described above could be very helpful in conjunction with a few quick  and helpful nutritional tricks. A small supplementation of olive oil, chromium, or  glutamine can usually reverse this common complication.
Natural remedies to help sleep are valerian root, 5-hydroxy tryptophan, passion  flower, GABA, and melatonin. Relaxation or meditation training and other natural  approaches can do much to restore good sleep. This is a bit more complicated than  it sounds; we advise that you consult with a professional. Of course, some  medicines can also help with sleep as long as care is taken to not create a habit or  dependence on these drugs. Reducing alcohol as well as reducing caffeine and  sugar will help the body sleep better.
The most interesting recent research is that the kinds of medicine that work best for  fibromyalgia and myofascial pain are not the traditional narcotic pain suppressors  such as vicodine, codeine, or the highly potent, non-steroidal, anti-inflammatory  medicines such as Celebrex or muscle relaxers such as Flexeril.
The best medicines acrording to Dr. Podell to use instead are those that act on our  nervous system and neurochemistry to reduce and reverse allodynia, the body?s  abnormal increased sensitivity to that pain.
The most surprising news is that many of the best new medicines are actually old  standbys that have been used for many years for other conditions. Because of the  complexity of fibromyalgia, we are just re-discovering the beneficial effects for  helping the neuro-chemistry. Some of the common medicines used are Baclofen,  Elavil, Flexeril, Gabatril, Klonopin, Neurontin, Paxil, Sinequan, Serzone, Xanax, and  Zofran.
The above medications, of course, can cause some side effects in some people, so  see your doctor for any questions you may have.
Biochemistry and Metabolism
Since every body is very individual there are laboratories specializing in diagnosis  that can help us detect metabolic imbalances and dysfunctions.
1. Essential fatty acid analysis which often shows a deficiency of omega-3 essential  fatty acids. Certain amino acids analysis often shows a deficiency of the chain  relationship of amino acids, with glutamine, taurine, tryptophan or tyrosine being  the most common.
2. Other theories pertaining to alterations in neurotransmitters like serotonin and  nor epinephrine. As mentioned before, substance P has an immune system function.  Substance P is a pain neurotransmitter that has been found by repeat studies to be  elevated three-fold in the spinal fluid of fibromyalgia patients. Two hormones that  have been shown to be abnormal are cortisol and growth hormone (HGH).
3. A comprehensive digestive and stool analysis can point to digestive enzyme  deficiencies, yeast, candida or Epstein-Barr, bacterial overgrowth, or even parasites,  which most people will have. The key is your immune system can usually handle it  and when it can?t then you succumb to worse problems.  I feel that enhancing or strengthening the immune system is the best way to  improve health with any disease.
4. Food allergies can be tested for as well or detected by going on an elimination  diet. ?Sensitive? food allergies can be identified that can make pain symptoms  worse. Be careful with cleansing diets as I have found most people need building  foods first due to poor eating habits. Urine tests for milk- or wheat-derived opioid  peptides can pinpoint digestive abnormalities that lead to toxic by products. We  have found most people are allergic to dairy products as well as to gluten found in  wheat products.
5. We used to do hair analysis or DMSA provoked urine testing to detect high levels  of toxic metals like mercury or lead. Now we have many other systems for  diagnosing and finding problems of that nature.
6. Checking the liver functions and enzyme levels is another way to find problems  as the liver is a key organ for cleansing the body.
7. Ordering a screening T4/TSH is a good first approach as well. Many of the  symptoms of fibromyalgia mimic hypothyroid muscular disease. Your doctor should  order a screening thyroid test as part of the initial workup of fibromyalgia.
8. Checking for hyperthyroid is also done quite easily in the laboratory. Just make  sure you are working with someone that takes the time to eliminate other potential  problems that could appear as FMS.
Body-Therapy and Mind-Body Therapies
Great relief may come with just getting massage, however, it can also aggravate  your condition so usually gentle massage is recommended and not deep tissue  work. One of the best techniques for these painful bands is DTF (Deep Transverse  Friction), made popular by Dr. James Cyriax. You should see a professional massage  therapist trained in this technique.
Trigger point therapy is another technique that helps reduce the stress in the  tissues and also should be done with great care. As you will find, within these taut  bands of muscle are extraordinarily sensitive pain points.
There is in the realm of body-mind techniques several that have proven effective in  neurological balancing. The most popular and widely used are Traggering and  Feldenkrais created by two extraordinary people who were pioneers in body-mind  therapy. Milton Tragger was an M.D., a neurosurgeon who created a movement type  of treatment that is gentle and achieves deep levels of relaxation through rocking  motions. He was a friend and I got to know him in Honolulu and experience his  work directly. We exchanged a few sessions with each other. It is very great, gentle  system of work, soothing to the nervous system.
Feldenkrais was once associated with Ida Rolf, the mother of Rolfing. Rather than  doing deep body work on the fasciae like Rolfing, Feldenkrais worked with certain  body postures and movements to free up the patterns in the body since it often falls  into poor posture and pain. Using movement and re-education of the body was his  approach. His theory was to break up the neurological patterns of pain and  restrictive movement.
There are a few others that are similar: Aston patterning, Alexander Technique, and  certain types of polarity therapy can all be helpful. Often it?s not the technique as  much as the belief of the effectiveness of the therapy by the patient.
More Mind Techniques
Of course, one of the best mental treatments for chronic pain and chronic illness,  which takes a psychological toll on the mind as well as the body, is bio-feedback  training, or some kind of relaxation or meditation techniques. These systems have  been around for thousands of years, and only in their application do we think they  are new.
There is a very useful technique call Neuro-Linguistic Programming or NLP, another  mental tool that changes the physiology by focusing on a positive new pattern  rather than on the old problem. And all of Tony Robinson?s work is very powerful for  transformations. I was lucky to have met him in the old days when I gave him a  treatment and took all his seminars.
Just good old-fashioned deep breathing can do wonders for the pain and the stress  level of any individual. Yoga and all the many forms of movement as we talked  about before, tai chi or ballroom dancing, for anyone for that matter, may be  helpful.
What To Do If You Have FMS
In the long term, the most important thing you need to understand is that the first  step is to understanding your fibromyalgia syndrome. We know that it can be  chronic, but the symptoms or your episodes may flare up - or mellow out. This, we  feel, can depend on your stress level, as well as what you have been doing to work  on improving your condition. The impact that FMS has on daily living as well as  activities is going to be different with each individual. It is commonly accepted that  FMS can be as serious as rheumatoid arthritis in disabling people from working  fulltime jobs.
Many patients have felt helpless or hopeless, and generally get very little relief or  poor results. We must remember the best results come from using all the tools and  methods available. It takes knowledgeable people as well as your commitment to  becoming informed to begin getting better. Know that FMS is not a life-threatening  disorder, although we can?t say it?s harmless. Some on the far end of the spectrum  may feel like they can?t live like this, but on the other side, some people can do well  and live a good life.
Get your doctor to do the laboratory tests to rule out other possible maladies that  can overlap or appear as FMS. One is hypothyroidism; it can be over-diagnosed but  most commonly it?s misdiagnosed. Fibromyalgia patients must have a good and  thorough clinical diagnosis. Qualified medical doctors or osteopaths must make this  diagnosis and ideally rule out other possibilities.
This disease can be confused with or be similar to MS (multiple sclerosis), lupus,  osteoarthritis, rheumatoid arthritis, and even heart problems. You may have TMJ  (temperomandibular joint syndrome), candida, Epstein-Barr syndrome, or CFS  (chronic fatigue syndrome), or even Lou Gehrig's disease, a brain tumor, spine  disease or a whole bunch of other problems. The only way to know it?s FMS is to  rule out some of these others, and only a qualified medical or osteopathic doctor  can do this.
Fibromyalgia Network for a listing of patient contacts and physician referrals.  www.fibromyalgia.com  The phone number is: (800) 853-2929.
For Othon see http://www.molinamassage.com for more information and other  articles.
May health be with you in all ways. . .
Othon Molina Ph.d. c LMT has been involved in the health field as a manual therapist  and personal trainer for over thirty five years. He has studied with some of the top  doctors and healers of our times. His specialty is treating sports injuries, back   problems, and teaching others how to improve their health or athletic competition  using nutrition and fitness technologies.
One of his specialties is Kinesiology, and sports training.  He has been a runner all  his life, and competed in many triathlons, 5k's, 10k's and marathons. Competing at  an elite level gave him the experience to help train others. Recently he coached and  worked with the female champion of the German team of triathletes.
Some of his clients include: Bob Hope, Jane Seymor, Essam Kashoggy, Jim Nabors,  Tony Robbins, Mark Victor Hansen, Carol Burnett, San Francisco Ballet, Allvin Alley  Dance troupe, some of the top Olympic and international elite athletes, team doc  and new trainer for the German professional triathletes. He also trains massage  teams as well as health professionals worldwide.