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WHAT DO I NEED FOR FIBROMYALGIA? Symptoms * Possible Causes * Therapies * Taking back your life! Contact us at AWW for an appointment and personalized help. As health advisors we will evaluate your health and symptoms. We will focus on your personal needs and help you formulate a plan to support your body and well being with information, specific nutrients, medications and therapies as you seek health and well being.
Pain All Over”/ “Irritable Everything”/ “Pain Amplification” Syndrome! WHAT IS FIBROMYALGIA? Fibromyalgia is a distinct disorder characterized by widespread pain (primarily musculoskeletal and myofascial tissues) accompanied by a host of various other symptoms. It has been called the “Irritable Everything” disorder perhaps reflecting a false perception of stimuli from our senses by the brain. “According to the American College Of Rheumatology, approximately 5.6 million Americans, or nearly 2% of the population, now suffer from FM, making it the second most common rheumatologic condition after osteoarthritis.” Delicious Living. October 2002. It can occur at any age. Approximately 90% of FM sufferers are women. FM was first reported in 1816. In 1987 the AMA recognized it as a serious illness. This cluster of symptoms was officially recognized as a syndrome in 1933. While FMS has no cure and the cause or causes of FMS are unknown, increasing therapies, research, and knowledge about this illness are helping to complete the puzzle and provide better quality of life for those with FMS. Jacob Teitelbaum, MD.”reports that symptoms decreased and quality of life improved for 91% of his FM study subjects while they received nutrition-supplement-focused treatment targeting disordered sleep, hormonal deficiencies and nutrient support.” Delicious Living. October 2002. “FMS is defined by the existence of specific tender points (1990 Am College of Rheumatology), sleep disturbances, stiffness, anxiety, depression, headaches, irritable bowels.” Family Practice Review Vol. 18, No. 6, June 1996. These isolated tender points are painful upon pressing with the fingernail until the nail bed starts to turn white, but the pain does not radiate to other areas. Pain must be located above and below the waist and on both sides of the body. Tender points and pain are common where an injury has occurred, in the upper back and in the neck. Recent guidelines suggest the presence of as few as 3 of the 18 distinguishable tender points as criteria for diagnosis of FMS. New research supports possible causes of FMS as being a sleep disorder, neurotransmitter dysfunction, pain perception abnormality involving the brain and spinal chord, or immune system overload. Because it is common to have FMS, Irritable Bowel Syndrome, Chronic Fatigue Syndrome, and Chronic Pain at the same time, these syndromes may be interrelated or have a common underlying etiology. FMS and Chronic Fatigue Syndrome have muscle and joint pain, sleep disorder, headaches, depression and cognitive impairment. “Although the bad news about CFS is we still don’t know what causes it, we do have 4,000 studies that show abnormalities in patients with this illness,’ said Harvard professor Anthony Komaroff, MD.” Studies have shown differences in the brain’s hormone system among people with CFS. Studies also reveal impairment of cognitive function and the autonomic nervous system that could explain some of the symptoms.” American Medical News. November 27, 2006. An in depth list and discussion of possible causes is provided below. An article in Spine. 2004 July 1;29(13):1436-40 suggests that “Patients who have neck pain demonstrated greater activation of accessory neck muscles during repetitive limb task compared with asymptomatic controls…which may represent an altered pattern of motor control to compensate for reduced activation of painful muscles. Greater perceived disability may account for the greater electromyographic amplitude of the superficial muscles during performance of the functional task.” New 2006 studies suggest that there is a relationship between increased inflammatory levels in depressed and traumatized patients and an exaggerated response to acute stress. “It (studies that suggest a relation between stress, depression and inflammatory response) may thus provide a mechanism for the onset or exacerbation of chronic inflammatory conditions such as inflammatory bowel disease and irritable bowel syndrome.” CNS News. November 2006. Listed below are some key nutrients that may help your body combat stress, reduce inflammatory processes, improve mood and cognitive function, support healthy circulation and maintain muscle health. WHAT YOU CAN DO The key to boosting the body’s innate ability to maintain and restore health in the face of chronic conditions is support of all the body’s interrelated processes. Two approaches are paramount. 1. A comprehensive supply of all natural nutrients in the diet and supplements is foundational. 2. Focus on whole life management (body, soul and spirit) which helps implement lifestyle changes and includes therapies, coping skills, social support and environment modification. FIBROMYALGIA SUPPORT CATEGORY Definitions Fibromyalgia/Myofascial Syndrome: (fye-bro-my-al-jia/my-o-face-shial-sin-drome) widespread aches and pain in specific tender points for at least 3 months and often accompanied by other symptoms. Fibro: fibrous tissue that makes up connective tissue My: muscle Al: pain Gia: condition Myofascia: fascia “A sheet of fibrous tissue which envelopes the body beneath the skin, and also encloses the muscles and groups of muscles and separates their several layers or groups.” Stedman’s Medical Dictionary Chronic: on going dysfunction and presentation of symptoms Disease: illness with specific cause and understood mechanisms Syndrome: “A concurrence of symptoms…(that constitute) together the picture of the disease.” Stedman’s Medical Dictionary. Symptom:. “Any morbid phenomenon or departure from the normal in function, appearance, or sensation, experienced by the patient and indicative of disease.” Symptoms 1. Pain. Widespread pain may manifest as aching (like lower legs), throbbing or distinct points of pin prick pains in the muscle/myofascial/skeletal system, head, neck, upper back, extremities, face, scalp, etc., and may including phantom pain, referred pain triggered by pressure, pain or damage in another area. “Patients with neck pain demonstrated greater activation of accessory neck muscles during repetitive limb task compared with asymptomatic controls…which may represent an altered pattern of motor control to compensate for reduced activation of painful muscles. Greater perceived disability may account for the greater electromyographic amplitude of the superficial muscles during performance of the functional task.” Spine. 2004 July 1;29(13):1436-40 2. Sleep abnormalities or poor sleep (an absence restorative sleep or deep REM sleep). 3. Chronic headaches and/or migraine. 4. Irritable bowels (intestinal cramping, fluctuating constipation/diarrhea). 5. Fatigue especially morning fatigue usually better in evening. 6. Mood disorders such as anxiety/depression. (affective disorder) 7. Hypersensitivity to smells, sounds (noise of fluorescent lights), light, vibrations, cold which is interpreted as highly uncomfortable or pain. There is some evidence of changes in nerve endings (nociceptors) that transmit pain to the brain. 8. Bouts of poor cognitive skills, fuzzy thinking, poor memory 9. TMJ or jaw pain 10. Seasonal Affective Disorder: Depression and worsening of symptoms influenced by changing of seasons. 11. Vision problems: hypersensitivity to light which can be exaggerated by strobe effect or intensity of automobile lights at night, and include sensitivity to patterns, blurring, double vision, floating shapes of snow like perception in field of vision. 12. Disturbed balance and coordination, dizziness 13. Feeling of tingling or numbness in extremities 14. Increase in symptoms after exertion (exercise) 15. PMS 16. Temperature regulation abnormalities. 17. Hypoglycemia 18. Allergies 19. chest pain without specific cause 20. heart palpitation 21. ringing in ear Diagnosis Some physicians make a diagnosis of FM if chronic pain is added to a list of overlapping chronic symptoms that characterize other syndromes and a diagnosis of Chronic Fatigue Syndrome (CFS) is made if fatigue is added, etc. Is FM a musculoskeletal abnormality, CFS an immune system disorder and chemical sensitivity a neurotransmitter dysfunction, or do they have the same etiology (cause or causes) such as a genetic defect, stress overload or our inability to handle an infection? “For most people, if they’re always tired, have brain fog, and can’t sleep, they either have CFS (Chronic Fatigue Syndrome) or fibromyalgia, or both,” says Jacob Teitelbaum, M.D. (author of Fatigued to Fantastic, Avery, 2001) adding that 70 % of people with FM also meet the criteria for CFS as recognized by the CDC.” “Without 7 to 10 hours of sleep, you will be in pain.” Healthy Edge. July 2002. ?Chronic conditions often exhibit depression, anxiety, and poor sleep. Geriatrics. December 2000 Vol. 55, Number 12. Do chronic illnesses share a common etiology of sleep abnormalities which prevent restorative sleep or are chronic illnesses the etiology of disturbed sleep? Causes Possible causes include genetic predisposition, musculoskeletal disorder, immune system dysfunction, sleep disorder, circadian cycle dysfunction, auto immune disorder, inflammatory response, antibodies against neurotransmitter serotonin, food or chemical allergies, nutrient deficiencies and metabolic abnormalities, stress overload, injury or abuse (physical/mental/environmental, specific physical injury or surgery), post traumatic syndrome, chronic fatigue syndrome, mood disorder (depression/anxiety/psychosomatic), brain/spinal chord abnormalities (substance P in spinal chord), neurotransmitter dysfunction, pain perception abnormalities (pain amplification), hypersensitivity to input from senses, microbial pathogen (virus, bacteria, bacterial, yeast….), adrenal/hypothalamus/pituitary axis dysfunction (low thyroid), hormone imbalance, adaptive behavior or poor coping skills, low blood sugar … “Fibromyalgia sufferers have evidence of allodynia, the perception of pain from stimuli that do not normally induce pain.” The Female Patient. Vol. 25 December 2000. Pain amplification does not seem to originate with the pin prick at the sight of the finger, but seems to be amplified by the brain or in the spinal column/chord where a four-fold elevation of two pro-nociceptive peptides, substance P and nerve growth factor are found in the cerebral fluid of patients with FM. Clauw, DJ. J Musculoskelet Med. 1999;16 (suppl):S7-12. Neuropathic pain syndrome. “Although the etiology of pain associated with depression is unclear, studies have shown that depression and pain are common comorbid (occur together) conditions.” CNS Special Report, November 2007“Chronic pain and psychological conditions are intimately intertwined, according to Edward Covington, MD. Therefore, management of mood disturbances is essential in effectively treating chronic pain, optimizing the patient’s quality of life and improving treatment outcomes.” Pain Medicine News. March/April 2005. Vol. 3, No. 2. Perhaps, stress induced overload could cause the pain of FMS. The body can be wrong about the level of danger present and constantly be on alert. This puts the body in a constant state of “flight or fight” mode which can overload the body and lead to immune system weakness. This affects the heart, muscles, blood pressure, slows blood to areas not needed for fight such as your digestive tract and extremities. It is hard to balance the body/mind response (voluntary and involuntary) to inaccurate evaluation of the reality of danger present. It is easy to see why depression and anxiety can be a result of chronic syndromes and chronic syndromes can result in pain. Two studies reported in Family Practice News. November 15, 2006 that major depressive disorder was helped (in, particular, sexual dysfunction) by an antidepressant that normalized disruptive circadian rhythm. “ New findings prompt interest in sleep disorder, neurotransmitter dysfunction or pain perception abnormalities involving the brain and spinal chord as possible causes. “Although fibromyalgia has many facets, the central cause of the pain of fibromyalgia is a low level of serotonin. Chronic low levels of serotonin cause the sensation of pain to be greatly exaggerated. The primary treatment goals in fibromyalgia in addition to those for Chronic Fatigue Syndrome are to raise serotonin levels, improve sleep quality, and assure adequate magnesium levels…The deeper levels of sleep (stages 3&4) are not achieved for long enough periods. As a result, people with fibromyalgia wake up feeling tired, worn out, and in pain. The severity of the pain of FM correlates with the rating of sleep quality. ” Murray, Michael and Pizzarno, N. D. Encyclopedia Of Natural Medicine. New York, New York: Three Rivers Press,199. Because it is not uncommon to have FMS, Irritable Bowel Syndrome, Chronic Fatigue Syndrome and other chronic symptoms at the same time, they may all be inter related or have the same underlying etiology. Whatever the cause of FMS, the very perceptions that allow the brain to make decisions about what we feel, see, hear, how we move, respond to stress, process emotions, and enjoy life seem to be inaccurate for the FM patient. Today, there are more questions than answers about FMS. There is, also, mounting research that supports actual physical, mental, and metabolic abnormalities even though current parameters used in clinical medicine to test pain, muscle damage, nerve damage, etc. are often normal. One such study from Family Practice News headlined studies showing that “deficient Growth Hormone (GH) secretion is common among FM patients …and share many clinical features, including muscle weakness, reduced exercise capacity, chronic fatigue, and feeling of social isolation.” Family Practice News August 15, 1997. Vol. 27, No. 16. WHAT DO I NEED? KEY NUTRIENTS + LIFE MANAGEMENT Nutrients Because some nutrients are quickly depleted during stress or illness, a daily supply of specific nutrients can help the body repair cells, flush toxins from the body, prevent damage by free radicals, support healthy sleep, boost metabolism, and support brain function... A healthy immune system can better resist illness and reduce the length and severity of symptoms! Included in Adobe Walls’ arsenal of defense are optimal levels of concentrated plant based nutrients and proprietary blends of herbs that may support the body's inherent ability to support these interconnected processes. “Because nutritional deficiencies are common in people with this problem (FM), it would be wise to make sure your diet provides optimum nutrition. To make absolutely sure you are giving your body what it needs, add appropriate supplements to your daily regimen.” Zand, Janet. Spreen, Allan. LaValle, James. Smart Medicine For Healthier Living. 1999. Avery Publishing Group, Garden City Park, N.Y. “It has been suggested that vitamin D levels may be linked to increased Fibromyalgia Pain,’ Dr Alan Braun, MD noted during the 2004 meeting of the American College of Rheumatology that ‘the association between fibromyalgia and reduced Vitamin D levels may be related to the fact that muscle cells contain receptors for vitamin D, making them targets for the activity of vitamin D in the body’.” Pain Medicine News. March/April 2005 Vol. 3 No. 2 Jacob Teitelbaum, MD, Annapolis Research Center for Effective FMS/CFS Therapies, prescribes intravenous vitamin therapy for some FMS patients. Boswellia serrata from India has antioxidant, anti-inflammatory properties. “The use of compounds isolated from the gum resin to treat inflammatory conditions, are inhibited by the primary constituents of B. serrata. (Wein Med Wochenschr. 2002:152:373-8; Eur. J Med. Res. 1998;3:511-4) One such condition is irritable bowel disease. Promising results have been reported … to treat…and rheumatoid arthritis. (Wein Med Wochenschr. 2002:152:373-8). This may be helpful therapy for fibromyalgia symptoms and may support the theory of an inflammatory cause. We invite you to check out the nutrients we offer in the Table above or in our Supplements Catalogue. Life Management Therapies*Coping Skills*Social Support*Environment Modification Introduction Below are a few tools for managing your life in your on going quest for maximizing health and life. “Healing is personal and subjective and can’t be quantified. You simply can’t measure objectively when it occurs. Only the patient can tell you.” “A patient that is seeking to balance spirit, soul and body while addressing a physical illness or injury may have a sense of wellbeing that many who are physically healthy do not enjoy.” Medical Economics, September 15, 2006 A. Earl Mgebroff, MD. Conversely, a patient seeking healing of soul or spirit may have a level of physical health that many who are emotionally healthy do not enjoy. Health is more than an absence of illness or injury. Wellness focuses on the value of life while seeking optimal body functioning and fostering zest for life even in the face of chronic dysfunction. Health implies a wholeness that transcends the broken (no matter the cause) and focuses on the value of life. 1. Therapies *Hot shower upon waking to loosen stiff muscles, increase circulation *Warm bath before retiring can be helpful. (Try Epsom Salts (magnesium), aromatherapy bath salts, essential oils). Whirlpool baths. *Massage (Two tennis balls in a small sock can serve as massage. Put the tennis ball sock between yourself (your upper back) and the wall. Let the ball slide down your back as you work different sore points or tight muscles. You can also use the tennis ball sock between you and the bed for a softer effect. Two socks or a small plastic water bottle filled with hot or cold water can be worked under your legs.) Sufferers often experience pain which appears to be caused by knots in muscles, painful joints and tight fascial layers which respond to manipulation. *Heat applied to muscles. Keep room warm. *More sleep, short naps, sleep medication *Magnets have been successfully used by some in the areas of pain *Exercise- low impact movement: dancing, less strenuous exercise, walking, swimming, stretching “Aerobic exercise has been shown to improve physical functioning and mood and to relieve symptom severity in patients with fibromyalgia…studies indicate that vigorous, regular exercise and psychotherapy are effective.” Keller, MB. McCollough, JP, Klein, New England Journal of Medicine 2000:342:1462-1470. *Acupuncture A 2006 study has reported that acupuncture was found to be effective in the treatment of fibromyalgia-related fatigue and anxiety. “I would recommend acupuncture for patients who have trouble tolerating medications’, David Martin, M.D. PhD, Mayo Clinic Rochester, Minn. ‘Accupuncture can interfere with pain signal’s, said John Sarno, MD, New York University School of Medicine…he describes the underlying cause of fibromyalgia as a manifestation of tension mysositis syndrome. Like other musculoskeletal maladies (e.g., bad backs, carpal tunnel syndrome) and gastrointestinal tract disorders (e.g., irritable bowel syndrome), fibromyalgia is a psychogenic condition that arises to distract the patient from rage and emotional pain’, related Dr. Sarno. Dr. Martin relates that acupuncture has worked well for myofacial pain’.”CNS News October 2006 *Acupressure: Acupressure can target tender points and muscles groups. *Aromatherapy: Aromatherapy can be calmative or stimulating and benefits mind and body. 2. Coping Skills Cognitive Behavioral Therapy. "Smile a lot, laugh often, enjoy good things and good people, eat only healthy foods, sleep well, have fun moving (include fun exercise as a part of your day), support any acute and chronic symptoms and reduce emotional stress and you will feel better." AWW “…CBT in chronic pain management stems from the belief that the experience of pain and suffering is the result of a complex integration of pathophysiology, cognition, affect, and behavior. Enrollment in a formal CBT class is ideal; alternatively, patients can buy books or log onto web sites that teach fundamental principles…relaxation training, activity pacing, pleasant activity schedualing, visual imagery, distraction strategies, cognitive restructuring, problem solving, and goal setting.” The Female Patient. Vol. 25 December 2000. Life is to be enjoyed with or without illness or handicaps. Who is better than you to help your body cope? Everyone has limits. You can have limits without being disabled. A cheerful soul knows no boundaries. *Develop a plan for flare ups. *Manage your time, energy and limit your responsibilities. *Do what you enjoy. *Cut yourself lots of slack. *Give to yourself first so you will have more to give to others. *Do those things that allow you to forget about your symptoms for a little while (reading, talking on phone, hobby, volunteering, a movie…). *Go to bed at the same time and get a consistent number of hours of sleep each night. Control your sleep environment. * REDUCE STRESS! 3. Social Support Supportive people are crucial in managing any chronic illness. This quote by Dr. A. Earl Mgebroff emphasizes the important of social support in promoting health. “Healing is related to wholeness, and wholeness is experienced in connection with others. It’s the whole person who comes to us, and it’s our job, as physicians, to try to recognize that fact. It’s also our job to help the patient integrate the best of each aspect-physical, emotional, intellectual, social, and spiritual-to create a truly whole person. My patients taught me that illness can facilitate connection-with other people and with things around us. A healer is somebody who helps patients make those connections.” “You can be healed and still have a physically sick body. It’s possible to be healed without being cured. And, I suppose, the reverse can be true. You can have no objectively demonstrable disease process and yet not be healthy and whole.”Medical Economics, September 15, 2006 A. Earl Mgebroff, MD FMS patients need daily support, emergency support, periodic backup and assistance to avoid being overextended physically and emotionally. Support people can help the patient with FM keep a realistic assessment of their environment, their abilities and their worth. The amount of your doing should not be equated with quality of your being. 4. Environment Modification Customize your environment to meet your needs. Reduce STRESS!!! *For some modifying their sleep environment can be of great benefit to insure a dark, quiet room, to keep the room a consistent temperature and the body from getting chilled (wearing warm clothing in a slightly cool room) and to provide freedom from stimuli which interrupt sleep such as jiggling of the bed. Eating several hours before bedtime and avoiding vigorous exercise in the evening can aid sleep. *Generally avoid bright or pulsating lights, loud noises, perfumes and harsh cleaning products. *Avoid congested malls or too many people in a room. *Avoid harmful substances such as tobacco, alcohol, saturated fats, trans fatty acids, caffeine, sugar… *Eliminate toxins: Drink pure (distilled water), breathe fresh air and eat all natural (unaltered, unprocessed foods). 5. Chronic Illness: Click here or see AWW's Health Topic Chronic Illness Summary Even though the causes are not clear cut, there are many things you can do to help yourself if have fibromyalgia. Some of the symptoms and perhaps some underlying causes may be helped with nutritional therapy and life management skills. We can help you learn about fibromyalgia and the nutrients that are beneficial, and be a reliable source of natural supplements. Let AWW Help You Put It Together Southwest Living Naturally! (CLICK HERE FOR More about CHRONIC ILLNESS.) “Our goal is your health and personal fulfillment in the face of chronic problems without clear causes. We do this by helping your body’s innate ability to restore health (physical, mental, and spiritual) with integrated traditional and alternative holistic therapies.” AWW "Smile a lot, laugh often, enjoy good things and good people, eat only healthy foods, sleep well, have fun moving (include fun exercise as a part of your day), support any acute and chronic symptoms and reduce emotional stress." AWW |
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