According to the textbooks, fibromyalgia is the name given to a collection of chronic symptoms of widespread pain for which no clear physiological cause can be found.
A term first introduced in 1981, it literally means pain (algia) in the muscles (my) and connective tissues (fibro). For years, the lack of an obvious cause condemned patients suffering from this condition to be often dismissed out of hand as hypochondriacs. In addition, it hasn’t helped male doctors’ understanding of the condition that over 90 per cent of sufferers are women.
In 1990, however, the American College of Rheumatology finally acknowledged fibromyalgia as a genuine condition with a specific constellation of symptoms. They can be widespread musculoskeletal pain, persisting for at least three months, with no evidence of inflammation or muscle abnormality. A key feature is a multiplicity of tender points at specific sites of the body (Arthritis Rheum., 1990).
Since then, the symptom of fatigue has been added to the list, as there is a huge overlap with chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME). Clinicians now agree it is only by counting the number of tender points that doctors can distinguish between the two conditions.
US expert Kerry Bone, however, has found that fibromyalgia patients suffer far more sleep disturbance than people who have ME or CFS. To make it even more complicated, there is even an overlap with multiple chemical sensitivity (MCS). This allergic-type reaction to environmental chemicals shares many of the same symptoms as fibromyalgia, ME and CFS.
Whatever the label, it is clear that those who suffer from any of these conditions are finding it hard to be taken seriously by medical practitioners. The condition almost becomes intangible in terms of actual descriptions of where the pain is and how to evidence it. This leads to even more frustration.
Even worse, a survey by Peter Dawes of the North Staffordshire Royal Infirmary in the UK has revealed that many sufferers of fibromyalgia have to endure multiple operations such as arthroscopy, endoscopy, unnecessary appendectomy, bladder suspensions for urinary retention, laparotomy for seeking causes of pain and spinal surgery for back pain (Rheumatology, 2004).
Acupuncture has a long, proven history of offering pain relief, and the pain of fibromyalgia is no exception. In the US, doctors at the highly conservative Mayo Clinic in Rochester, Minnesota, ran a placebo-controlled trial involving 50 patients suffering fibromyalgia. Half received genuine acupuncture, while the rest were given fake acupuncture (the needles were inserted into the wrong places).
The patients’ progress was tracked for up to seven months after treatment. Clear differences between the two groups were revealed. Those who had been treated with the real acupuncture reported significantly improved symptoms of fibromyalgia. The treatment reduced pain, fatigue and anxiety (Mayo Clinic proc., 2006).
Homeopathy has proved very helpful in treating this condition. A full-blown, double blind trial was conducted at the University of Arizona, in which half the participants were given an individually tailored homeopathic remedy and the others a placebo.
When tested three months later, the treated patients were significantly better than those taking the placebo. They experienced less pain, less tenderness, less depression and better health and quality of life.
Interestingly, fibromyalgia patients have been found to have abnormal levels of magnesium, and there is evidence that taking a supplement of 300mg/day of magnesium can improve some of the symptoms of fibromyalgia (J. Rheumatol., 1995). A daily dose of Ginkgo biloba and coenzyme Q10, in combination, can also help.
Fibromyalgia patients suffer far more sleep disturbance than people who have myalgic encephalomyelitis or chronic fatigue syndrome
Intense physical exercise has also been found to be helpful (Curr. Opin. Rheumatol., 2007) together with more mind-related treatments. Cognitive behavioural therapy and mindfulness meditation, for example, have both shown promise (Altern. Ther. Health Med., 1998).
Several therapies that have proven not to work include static, magnetic-field therapy. A controlled trial compared the effects of genuine magnets with fake ones. There were no differences in skin tenderness or quality of life, and only a marginally significant decrease in pain (J. Altern. Complement. Med., 2001).
Chlorella pyrenoidosa, which is a freshwater species of green algae, is rich in proteins, vitamins and minerals, but has had disappointing results in clinical trials of fibromyalgia. (Altern. Ther. Health Med., 2001).
Finally, osteopathy: so far, the data from clinical trials using this treatment for fibromyalgia have been unconvincing (Curr. Pharm. Des., 2006).
Hopefully, this summary of fibromyalgia will help those who suffer understand how to treat their debilitating condition and find an answer to the constant pain.
kathryn@maltanet.net