Do you hurt all over and frequently feel exhausted for no reason? Despite all his x-rays and blood tests, can your doctor not find anything specifically wrong with you? These complaints are classic for people suffering from Fibromyalgia Syndrome (FMS). This is a chronic condition characterized by widespread pain in muscles, tendons, and joints as well as severe fatigue and multiple tender points on the body where even slight pressure causes pain. Misdiagnosis and mistreatment is rampant because there is no specific lab test for this disorder. The American College of Rheumatology does have standard classification guidelines, including widespread aching pain for at least 3 months and a minimum of 11 out of 20 standard points on the body which are abnormally tender to a standard degree of mild, firm pressure. Unfortunately, not all physicians are familiar with the syndrome or its diagnostic criteria, and some insurance companies still refuse to acknowledge it as a true medical condition. As a result, many people suffer for months or even years and even begin to believe the labels of laziness or malingering that they have received.
Most people with FMS also suffer other symptoms, including:
- Fatigue and sleep disturbances: you may wake up tired despite plenty of sleep.
Recent studies have determined that this is due to a sleep disorder called “alpha wave interrupted sleep pattern”, in which deep sleep is frequently interrupted by bursts of brain activity similar to wakefulness. Therefore, the individual misses the deep restorative stage of sleep. Nighttime muscle spasms and Restless Leg Syndrome also contribute to fatigue levels.
- Digestive problems: Irritable Bowel Syndrome and other related disorders are common.
- Headaches, facial pain and TMJ dysfunctions: frequently, these symptoms arise from stiffness and muscle imbalances in the neck and shoulders.
- Emotional issues: depression, anxiety, and mood swings commonly occur, both as a result of neurochemical changes, and as a side effect of many medications.
- Numbness and tingling in the hands and feet
- Cognitive deficits: decreased memory or difficulty concentrating are common
- Dizziness, either constant or in sporadic bursts
- Dryness of skin, eyes, and mouth
- Non-cardiac related chest pain and pressure
- Abnormal menstrual periods that may be erratic or painful
The cause of FMS is unknown, although theories abound. The most widely accepted current hypothesis, the “central sensitization” theory, states that sufferers of FMS develop a lower pain threshold due to an increased sensitivity in the brain to pain signals. Repeated stimulation via pain stimuli causes the brain to change, producing an abnormal increase of neurotransmitters (chemicals in the brain that signal pain). Also, the brain’s receptors, which receive signals from the neurotransmitters, develop a form of memory of pain and become more sensitive, causing them to overreact. The cause of this process has not yet been discovered. Other causative theories involve injury to the upper spinal cord, infection, childhood exposure to chemicals or toxins, metabolic changes, psychological stress, hormonal changes, sleep disturbances as a cause of the syndrome rather than just a symptom, enzyme deficiencies, abnormalities in the lymphatic drainage system, and abnormalities of the autonomic nervous system.
Standard treatment regimes consist of medications, including analgesics such as acetaminophen, aspirin, ibuprofen, or naproxen sodium. Unfortunately, these pain relievers tend to be less than effective, and overuse can lead to serious side effects. Antidepressants, sleeping pills, and muscle relaxants are commonly prescribed, with all of their well-known side effects. Anticonvulsants, medications typically used to treat epilepsy and thought to be helpful in dulling pain, are frequently used as well. The risk associated with taking medications for seizures, when no such imbalance exists, goes without saying. Patients also commonly receive cognitive behavioral therapy, in which they are taught how to manage stress and live with the pain. This is the approach most pain clinics adopt.
Physicians will tell you that the intensity of your symptoms will vary but never disappear completely. However, several patients have entered my clinic with a diagnosis of Fibromyalgia and now insist that they no longer suffer any symptoms, even several years after finishing treatment. At Golden Leaf Health Services, I use a holistic (whole body) approach, combining acupuncture, manual therapy, nutritional interventions, and patient education and self-care to get the results you need. My approach works very well in conjunction with that of your doctor-you do not need to choose one approach over the other.