Do you know someone with fibromyalgia? Do you have symptoms of this syndrome yourself? At the very least, I’m sure that many of you have heard about fibromyalgia. But there’s a lot of confusion and misunderstanding around the causes and treatments of this condition, and that has made it difficult to help women who are challenged by this disease. Fibromyalgia is influenced by a number of factors. If you are struggling with the disease, I want to encourage you to begin focusing on one or two of these factors; you can find that light within you that will begin to shine again. With renewed inspiration, I believe that you will have more energy to work on a achieving a healthy lifestyle, and be able to enjoy each and every day.
I often see women who are very discouraged about the advice on fibromyalgia that they’ve gotten in the past. They have daily symptoms that are very hard to deal with, including sleeplessness, fatigue, and ongoing pain that is nearly unbearable. Baffled by the confusion surrounding fibromyalgia and ignored by the medical profession for years, some people still wonder if they are getting a “real” diagnosis. Be assured that fibromyalgia is real. There are many women who deserve understanding and appropriate treatment for their life-altering symptoms. Specialists and functional practitioners are actively seeking answers to what causes fibromyalgia (and similar pain syndromes) and working on finding better ways to alleviate the symptoms.
What Is fibromyalgia?
Nobody is certain as to what causes fibromyalgia. It might be an energy deficit in the cells of the body, or mixed signaling among the muscles and the brain. It is known, however, that people with this condition have chronic pain in all parts of the body, and it involves a physical response to stress. The brains of patients with fibromyalgia have greater activation (shown on functional neural imaging) than patients who do not have fibromyalgia, when given the same stimulus. There is a clear physiologic difference in how fibromyalgia patients process symptoms of pain in their brains.
Diagnosing fibromyalgia
If you are experiencing pain and believe it could be fibromyalgia, don’t delay. Schedule an appointment with your doctor today. Diagnostic criteria for fibromyalgia from the American College of Rheumatology are that you have 11 of 18 specified spots that cause extreme pain when pressed, with widespread pain that has generally been present for at least three months.
Although those criteria were developed for, and are useful in, research purposes, they aren’t always sufficient in helping the patients we see every day. Fibromyalgia can be inconsistent, and pain can vary; so one tender point you have today may feel different on another day. Furthermore, research indicates that exposure to physical, emotional, or environmental stressors can enhance symptoms, and one day might be worse than another because of extra burden placed on the body from undue stress. There are also providers who don’t know how to properly locate tender points and tell the difference from trigger points related to other kinds of musculoskeletal pain. Seeing a practitioner that clearly understands fibromyalgia is essential when seeking help.
To add further complication, fibromyalgia symptoms are similar to other disorders, like chronic fatigue syndrome, myofascial pain syndrome (from repetitive motions), various chemical sensitivities, temporomandibular joint dysfunction (a jaw disorder), and interstitial cystitis (bladder infection), to name just a few. This makes it harder to diagnose. And because of the number of symptoms and possible disorders, it’s difficult to follow up with appropriate treatment. I think it’s more helpful to alleviate symptoms for the patient rather than continuing a quest for an elusive diagnosis.
Treating fibromyalgia
The US Food and Drug Administration (FDA) have approved several prescription drugs (Lyrica, Cymbalta, and Savella) for patients who are diagnosed with fibromyalgia. It’s a positive step in the right direction that the medical community is recognizing this disorder. However, I think that women who have symptoms of fibromyalgia need more than medication for their pain, especially because the first FDA reviewers of Lyrica (initially looked at to treat diabetic nerve pain) thought that its effects were not very impressive. In addition, Lyrica’s side effects include weight gain, swelling, dizziness, and drowsiness – the very symptoms that a fibromyalgia patient is trying to avoid!
Having worked with fibromyalgia patients for years, I know that treatment through drugs isn’t the best treatment option. I have helped many women feel significantly better, and some have even recovered completely. The first step is for these women to learn ways to nurture their body from the inside out. This condition is at a woman’s core, where there are many antecedent issues to look at. These may include sleep, nutrition, digestive problems, adrenal dysfunction, viruses (such as Lyme disease), other infections, and how a woman thinks and feels. It can be a challenging journey as you embark on this mission to feel well again. But if you are willing to dig deeper and do the work, I can promise you that it can happen. Let’s take a closer look at fibromyalgia and some alternatives to help you feel better naturally.
Issues related to chronic pain
There are a variety of underlying factors that can lead to unrelenting pain, in several categories including nutrition, metabolism, infection, and toxicity. Discuss these concerns with your healthcare provider.
Nutrition
- Low ferritin
- Low B12
- Low folic acid (blood)
- Low 25-hydroxy vitamin D
- Low vitamin C, B1, and B2
Metabolism
- Hypothyroidism (low thyroid)
- Adrenal Dysfunction
Infection
- Lyme Disease or coinfections
- Hepatitis C
- Ova and parasites
- Overgrowth of bacteria in the gut
- Enteroviruses
- Other infections not known or not yet understood
Toxicity
- Heavy metals
- Pesticides
- Jet fuel
Adapted from Gerwin, 2005.
Causes of persistent myalgias
| CAUSES | |
| Mechanical | Structural
Postural Ergonomic |
| Medical | Infectious disease
Inflammatory disorders Immunological/allergic Nutritional disorders Hormonal disorders |
Adapted from Gerwin, 2005.
It is difficult to be certain of the actual cause of fibromyalgia. If we take a closer look at your nutrition, infections you have currently or have had in the past, hormonal imbalance, metabolic challenges, and your emotional history we have a good starting point. The chart above lists various causes that can lead to myalgias, which are linked to fibromyalgia. It’s important for you to understand as much as possible about this disorder to help you and your practitioner create a good treatment plan.
Stress and hormones – are they connected?
You are probably already aware that hormones are vital to your healthy lifestyle. The hypothalamus (the master gland) sends biochemical messages to your thyroid gland, your adrenal glands, and your ovaries (among others) through your pituitary gland. This will regulate your metabolic balance, your immune system, your autonomic nervous system, and more. Then your body tissues send chemical messages back to the hypothalamus. The message and information loops influence the symptoms that are seen in fibromyalgia. Let’s explore the three locations that the hypothalamus communicates with.
Research shows that fibromyalgia patients may have disruptions in hormonal sequences. Because the hypothalamus and pituitary gland are central in governing many hormonal cascades, an imbalance in one area could easily affect the other areas. Scientists trace some of these disruptions to environmental and genetic influences, and also psychological stress.
Adapted from A. Gupta and A. Simon, 2004
Thyroid gland. An imbalance in your thyroid gland can actually stem from an adrenal gland imbalance. Research shows a connection between thyroid conditions and fibromyalgia, which seems to happen more often in menopausal women. The symptoms of hypothyroidism (such as low body temperature, poor immune function, fatigue, and achiness) can add to the intense symptoms of fibromyalgia. When you treat your hypothyroidism, your symptoms of fibromyalgia can improve.
Adrenal glands. A major duty of your adrenal glands is to release cortisol. You have a daily cycle of cortisol, and you also release it under stress. Fibromyalgia patients report they have a feeling of “crashing” under stress (probably because of an adrenal imbalance). Research suggests that there might be a link between emotional trauma and disrupted cortisol rhythms in people who have fibromyalgia. When you heal your toxic emotions and support your adrenal health, your stress response will improve. And so, too, will your symptoms of fibromyalgia.
Ovaries. Women with fibromyalgia usually have more severe symptoms premenstrually and postmenstrually. This is because estrogen, progesterone, and testosterone can affect bodily pain and fatigue. So if you can balance your hormones with thyroid, adrenal, and ovarian support, you can lessen the fibromyalgia symptoms. Remember that your fibromyalgia tends to improve as you age and your symptoms will decrease as you develop coping strategies.
Central sensitization theory and fibromyalgia
Fibromyalgia patients seem to feel more intense pain, and though it’s not understood why, there is some research that helps explain why. Scientists think that it begins in the deep tissues of the muscles and joints with a tightening of muscles, which leads to poor sleep. Without proper rest, the muscles can’t recover, and this can lead to continuous signals between your muscles and your central nervous system. This then alters the way that your central nervous system processes outside conditions; you will feel more pain and be more sensitive. This is known as central sensitization.
An interesting thing about central sensitization is that the causes and effects of fibromyalgia are thought to be bidirectional. This means that structural imbalances can cause your muscles to tighten, while tight muscles can lead to structural imbalances. In addition, poor sleep can lead to your muscles tightening, and tight muscles can lead to poor sleep. You get the idea and can see the vicious cycle, right?
How can you stop this cycle? Start with two basic steps — getting good rest and good nutrition for optimal muscle functioning. But there are other ways to decrease, and maybe even eliminate, your pain naturally. Let’s take a look.
What is the natural approach to treating fibromyalgia?
Medications such as Lyrica, Cymbalta, or Savella can help manage the symptoms of your fibromyalgia, but they are not a permanent cure. There’s an excellent book that discusses a natural approach: From Fatigued to Fantastic! written by Dr. Jacob Teitelbaum in 2007. In the book he details the concept of SHIN: Sleep, Hormonal imbalances, Infections, and Nutrition.
I’d like to add an E, for Emotions, to Dr. Teitelbaum’s protocol. As you are aware, your emotions play a large part in the symptoms of fibromyalgia. The new acronym spells SHINE, which is what I want to help you do naturally! Let’s discuss each one of these natural approaches in more detail.
Sleep. Most fibromyalgia patients say that lack of refreshing sleep is causing them major distress. Sleep is necessary to heal your muscles and your nervous system. If you think that you might have a breathing disorder that interferes with your sleep, please see a sleep specialist. You could also take 5-Hydroxytryptophan, which has shown to improve your serotonin pathways, or melatonin, which aids in resetting your sleep cycle. Before beginning any new supplements, be sure to talk with your healthcare provider. There are other botanical nervines (such as chamomile, passionflower, and valerian) that have also been safely used for years.
Hormonal balance. You can naturally balance your thyroid, adrenal, and ovarian hormones to make a difference in your symptoms of fibromyalgia. At marcellepick.com, I suggest that you try gentle phytotherapy. This will work with your metabolic pathways. For the best results, you should look for products that contain botanical nervines and/or adaptogens.
Immune health. Fibromyalgia symptoms can be caused by infectious agents (bacteria, enteroviruses, yeasts, or parasites). It’s a good idea to be sure that an infection is not present. Epstein-Barr virus, cytomegalovirus and Lyme disease are often associated with fibromyalgia and chronic fatigue syndrome. Ask your healthcare provider if you can be tested for these diseases, and treated if the results come back positive. You might also check to see if you have allergies that increase your symptoms. This could be sensitivity to gluten, eggs, corn, dairy, sugar, preservatives, and food additives. Try an elimination diet to determine if avoiding any of these things will help you. It’s always a good idea to boost your immune system and you can do this by taking a probiotic supplement.
Nutrition. Eating whole, fresh foods (fruits, vegetables, and high-quality fats and protein) is the best way to support your body. If you are under stress, I also suggest that you take a pharmaceutical grade multivitamin and mineral complex with fish-oil. Remember that your muscles, nervous system, adrenal glands, immune system, and your body as a whole need proper nutrition for their daily processes!
Some key nutrients that are helpful for fibromyalgia
- B-complex vitamins for energy, immunity, nerve, and brain function
- Magnesium for muscle energy
- Selenium for the best immune function
- Vitamin C for oxidative stress
- Fatty acids, such as omega-3 to help promote cell membranes and mood
- Vitamin D for mood, immunity, and the musculoskeletal system
- Zinc for cell health
- Iodine for thyroid health
Emotions. One of the most interesting thing I’ve discovered in my years of working with patients is how for every emotion we feel (both the positive and the negative) there is a biochemical signature that occurs in our bodies. Put in simpler terms, this means that if we hide our emotions and don’t adequately express them, these emotions will manifest in physical ways. In the 1990s, the ACE (Adverse Childhood Experiences) study found specific evidence about how negative experiences influence health. Adults can hold onto childhood memories and resort to previous behaviors that worked then. Of course, those behaviors don’t usually work for adults. If a grown person continues to engage in child-like emotional reactions, then he or she cannot resolve core issues. I have found that my fibromyalgia patients tend to be critical and judgmental of themselves. If they can learn to forgive and love themselves, then healing can more easily happen. There are several alternative methods to help deal with emotions, such as Emotional Freedom Techniques, the Quadrinity Process, and cognitive behavioral therapy. I’ve worked with women who were willing to look at their emotional issues and develop new coping strategies, which then helped improve their fibromyalgia symptoms.
While I think the SHINE protocol is great at looking at the whole picture, there are other natural treatment ideas that can help patients with fibromyalgia too. Here are other measures to support your fibromyalgia treatment:
- Detoxification. There are toxins everywhere, and your body is constantly trying to filter them out. Fibromyalgia patients can help stimulate their natural detoxification systems with saunas, steam baths, mineral baths, and low-intensity exercise to induce sweat. In addition, you can try to be “green” at home, reducing the toxins that are in your household by choosing detergents, cleaners and even clothing that is free of chemicals.
- Exercise. If you have fibromyalgia, you may have a hard time even considering exercise because of fatigue and muscle pain, and you probably have a fairly sedentary lifestyle. It seems so hard to exercise, but if you can just get started the positive results begin right away. This is not just about fitness – it will decrease pain sensations, improve restful sleep, enhance the thought processes, and create a more positive outlook on life. Especially helpful are aquatic fitness and wellness programs (“deep-water running,” aquarobics, isokinetics) that demonstrate great benefits for fibromyalgia. Additional research has found that whole-body vibration safely reduces pain and fatigue in fibromyalgia, even better than exercise alone. Begin slowly and gently, and make a plan to continue to exercise to help with your symptoms of fibromyalgia.
- Mind-body work. There are body awareness practices (qi gong and yoga) that help to improve “movement harmony,” in addition to breathing exercises and mindfulness meditation that help to decrease fibromyalgia symptoms. They work by calming the “noise” in your central nervous system. Other forms that you might want to try include acupuncture, biofeedback, massage, osteopathic manipulation, Feldenkrais, Alexander technique, and chiropractic. These can assist you by correcting structural imbalances and by regulating pain. There is also benefit in guided imagery exercises, such as Belleruth Naparstek’s meditation, to help with fibromyalgia and chronic fatigue.
Find hope in your own light
We all shine in our own special way. On good days, you feel plenty of positive energy and hope. But there are also days when symptoms of fibromyalgia make you tired, achy, and discouraged. Being told there is no solution, or that your symptoms aren’t real, can fill you with negative energy. I encourage you to believe that you do not need to be in pain for the rest of your life. And you don’t have to rely on prescription drugs to make it through the day either.
Reading this article and learning more about fibromyalgia is a great start. Now you understand that this syndrome is caused, and influenced, by many factors. You don’t have to tackle them all at once. If you choose to work on one or two of these factors, you will find that you can start to SHINE again. You can renew your energy and continue to look at the aspects of your life that affect your health. Soon you’ll be enjoying a healthier and happier lifestyle.
