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Fibromyalgia

Fibromyalgia

Description

Fibromyalgia (Fibrositis / Myofascial Pain) is a syndrome involving muscular (myo) pain (-algia) and stiffness, which is usually considered to be a form of arthritis.

Sufferers are often dismissed as malingerers, as definitive clinical findings may be absent. It is a source of considerable frustration for both clinicians and patients.

Basically, the sufferer may complain of tenderness at any site the examiner touches. In order to rule out malingerers, certain sites (12 - 14 in number) have become definitive and a measuring instrument (algometer) has been developed.

Current terminology demands that fibromyalgia sufferers have tenderness at certain sites, whereas myofascial pain sufferers have trigger points, referring pain elsewhere. However, even clinicians are confused about diagnosing these conditions, under any name, or classification.

Causes

Tension and bad posture seem to accompany the condition. Sufferers may also have chronic fatigue syndrome, or Epstein Barr Virus.

Basically, a tender spot in a muscle becomes established. If upon palpation, the pain may shoot from this spot (for example the trapezius) into an adjoining area (e.g. headache). In which case some authorities believe it should be reclassified as a trigger point and be termed “myofascial pain syndrome”, instead of fibromyalgia.

Signs & Symptoms

Classically, there will be extreme tenderness upon palpation at multiple sites, especially the neck and shoulder. Movement will be difficult, painful and characteristically stiff.

In some respects the symptoms are the same as with delayed onset muscular soreness after a heavy workout, except that there was no workout and the soreness never goes away.

The muscular soreness will often correspond closely with the trigger points identified by several authorities, notably Travell and Simons. The distinguishing characteristic, is that trigger points refer pain elsewhere.

Nutritional Supplements

Structure & Function:
        Immune System Support
        Circulatory Support &
        Nutrients for Brain Support


---------------------------------
General Supplements
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B Complex100 mg tid (Or Injections)
Bioflavonoids*
CoQ1075 mg
Lecithin*
Malic Acid & Magnesium
Manganese5 mg
Proanthocyanidins*
Selenium*
Vitamin A10,000 IU
Vitamin C5,000 - 10,000 mg
Vitamin E400 IU



*Please refer to the respective topic for specific nutrient amounts.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Drug Interactions

Drugs are the primary allopathic therapy to control the pain and inflammation associated with forms of Arthritis.

Most of the drugs diminish the production of prostaglandins, produced by the inflammatory process. [Vitamin E is a natural prostaglandin inhibitor.]

Today, the first line of attack comprises NSAIDs (Nonsteroidal anti-inflammatory drugs) including salicylates.

Side effects frequently include nutritional status.

Aspirin, for example, increases urinary excretion of vitamin C. Decreased vitamin status with respect to vitamin C as well as folate have been noted. There may also be extensive bleeding both with salicylates and other NSAIDs. An associated condition is anemia.

Methotrexate and Sulfasalazine (both used as NSAIDs) are associated with the greatest losses of folate and these drugs should be accompanied with daily supplements of folate.

Dietary Considerations

Fluids help flush out toxins.

Organic apple juice is a good source of malic acid.

Some foods, containing solanine, may aggravate the pain and discomfort, these foods include: green peppers, eggplant, tomatoes and white potatoes.

Homeopathic Remedy

DescriptionRemedy
Muscles ache all over:Aesculus hippocastanum
Arnica montana tinct.



Treatment Schedule

Over-the-counter homeopathic remedies may be single strength (of fairly weak potency e.g. 6X ) or a blend of several weaker strengths (6X, 8X, 10X).

This may comprise a single remedy, or several remedies.

Doses are administered on a 3 times daily (tid), between meals,schedule and continued for 3 days.

Liquid preparations usually use 8-10 drops per dose.

Solid preparations are usually 2 or 3 pellets per dose.

Children use 1/2 dose i.e. 1 pellet.

If there is aggravation of the symptoms, stop taking the remedy and consult a homeopath.

References

Murphy, R. : Homeopathic Medical Repertory. Hahneman Academy, Pagosa Springs, Colorado. 1993.

Murphy, R. : Lotus Materia Medica. Hahneman Academy, Pagosa Springs, Colorado. 1995.

Pert, J.C.: Homeopathy for the Family. The Homoeopathic Development Foundation, London. 1985 edition.

Herbal Approaches

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Herbs
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Astragalus
Black Walnut
Echinacea
Garlic
Ginseng
Licorice
Valerian

"Fibrositis"

Cayenne
Ginger
Wintergreen

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Discussion:

Astragalus and Echinacea enhance immune function.

Black Walnut and Garlic eliminate parasites.

Ginseng is a tonic.

Licorice supports the adrenals.

Valerian is used to promote sleep.

Cayenne, Ginger and Wintergreen can provide a rubefacient benefit to sore muscles.

References:

Hoffmann, D: The New Holistic Herbal. Element, 1983. Third edition 1990.

Aromatherapy - Essential Oils

Exhaustion:

Aniseed Essence,Basil Essence,
Bergamot Essence,Chamomile Essence,
Clary Sage Essence,Frankincense Essence,
Lavender Essence,Lemon Essence,
Neroli Essence,Orange Essence,
Thyme Essence,Wintergreen Essence.



Related Health Conditions

Allergy
Arthritis
Chronic Fatigue Syndrome
Epstein-Barr Virus
Food Allergy
Herpes Simplex
Mononucleosis
Osteoarthritis
Restless Legs Syndrome
Rheumatoid Arthritis
Sick Building Syndrome

Abstracts

References

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Block-SR: Fibromyalgia and the rheumatisms. Common sense and sensibility. Rheum-Dis-Clin-North-Am. 1993 Feb; 19(1): 61-78.

Blunt KL et al., The effectiveness of chiropractic management of fibromyalgia patients: a pilot study. J Manipulative Physiol Ther, 1997 Jul-Aug, 20:6, 389-99.

Bruce-E: Myofascial pain syndrome: early recognition and comprehensive management. AAOHN-Journal (AAOHN-J) 1995 Sep; 43(9): 469-74 (32 ref).

Celiker R et al., Psychological disturbance in fibromyalgia: relation to pain severity. Clin Rheumatol, 1997 Mar, 16:2, 179-84.

Clauw DJ et al., The relationship between fibromyalgia and interstitial cystitis. J Psychiatr Res, 1997 Jan-Feb, 31:1, 125-31.

Cunningham-ME: Becoming familiar with fibromyalgia. Orthopaedic-Nursing. 1996 Mar-Apr; 15(2): 33-6 (17 ref).

Dimmock S et al., Factors predisposing to the resort of complementary therapies in patients with fibromyalgia. Clin Rheumatol, 1996 Sep, 15:5, 478-82.

Disdier-P: Fibrositis syndrome and narcolepsy. J-Rheumatol. 1993 May; 20(5): 888-9.

Eisinger J et al., Protein peroxidation, magnesium deficiency and fibromyalgia. Magnes Res, 1996 Dec, 9:4, 313-6.

Fassbender K et al., Tender points, depressive and functional symptoms: comparison between fibromyalgia and major depression. Clin Rheumatol, 1997 Jan, 16:1, 76-9.

Fishbain-DA et al DSM-III diagnoses of patients with myofascial pain syndrome (fibrositis). Archives-of-Physical-Medicine-and-Rehabilitation. 1989 Jun; 70(6): 433-8. (24 ref)

Fitzcharles MA & Esdaile JM: The overdiagnosis of fibromyalgia syndrome. Am J Med, 1997 Jul, 103:1, 44-50.

Fitzcharles MA & Esdaile JM: Nonphysician practitioner treatments and fibromyalgia syndrome. J Rheumatol, 1997 May, 24:5, 937-40.

Goldenberg DL: Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome. Curr Opin Rheumatol, 1997 Mar, 9:2, 135-43.

Goldman-AL: Fibrositis: learn to recognize this common pain syndrome. Consultant, 1984 Jul; 24(7): 55-7, 59, 62-3. (6 bib)

Gerdle-B; Elert-J: Disability and impairment in fibromyalgia syndrome: possible pathogenesis and etiology. (Living with Continuous Muscular Pain, Part II: Strategies for Daily Life.) Critical Reviews in Physical and Rehabilitation Medicine. 1995; 7(3): 189-232 (321 ref).

Granges-G & Littlejohn-GO: A comparative study of clinical signs in fibromyalgia/fibrositis syndrome, healthy and exercising subjects. J-Rheumatol. 1993 Feb; 20(2): 344-51.

Granges-G & Littlejohn-G: Pressure pain threshold in pain-free subjects, in patients with chronic regional pain syndromes, and in patients with fibromyalgia syndrome [see comments]. Arthritis-Rheum. 1993 May; 36(5): 642-6.

Guthrie-NG et al: Comparing three techniques for the evaluation of fibromyalgia. Physiotherapy-Canada, 1994 Spring; 46(2): 94-7 (18 ref)

Hawley-D; Cathey-MA: Fighting fibrositis. American-Journal-of-Nursing, 1985 Apr; 85(4): 404-6. (17 ref)

Henriksson-CM: Living with continuous muscular pain -- patient perspectives. Part I: encounters and consequences. Scandinavian-Journal-of-Caring-Sciences, 1995; 9(2): 67-76 (27 ref).

Henriksson-CM: Living with continuous muscular pain -- patient perspectives. Part II: strategies for daily life Scandinavian-Journal-of-Caring-Sciences. 1995; 9(2): 77-86 (16 ref).

Hostmark-AT et al: Reduced plasma fibrinogen, serum peroxides, lipids, and apolipoproteins after a 3-week vegetarian diet. Plant-Foods-Hum-Nutr. 1993 Jan; 43(1): 55-61.

Lovy-MR & Wener-MH: Rheumatic disease: when is hepatitis C the culprit? Journal-of-Musculoskeletal-Medicine 1996 Apr; 13(4): 27-32, 35 (27 ref).

Nicolodi M & Sicuteri F: Fibromyalgia and migraine, two faces of the same mechanism. Serotonin as the common clue for pathogenesis and therapy. Adv Exp Med Biol, 1996, 398:, 373-9.

Nirregaard J et al., Muscle strength, working capacity and effort in patients with fibromyalgia. Scand J Rehabil Med, 1997 Jun, 29:2, 97-102.

Perlis ML et al., Alpha sleep and information processing, perception of sleep, pain, and arousability in fibromyalgia. Int J Neurosci, 1997 Feb, 89:3-4, 265-80.

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Regland B et al., Increased concentrations of homocysteine in the cerebrospinal fluid in patients with fibromyalgia and chronic fatigue syndrome. Scand J Rheumatol, 1997, 26:4, 301-7.

Reid GJ et al., Primary juvenile fibromyalgia: psychological adjustment, family functioning, coping, and functional disability. Arthritis Rheum, 1997 Apr, 40:4, 752-60.

Rook-JL: Geriatric pain management... part 2. Rehab Management: The Interdisciplinary Journal of Rehabilitation. 1995 Dec-Jan; 8(1): 25-6, 30, 32 passim. (33 ref)

Schaefer-KM: Struggling to maintain balance: a study of women living with fibromyalgia. Journal-of-Advanced-Nursing. 1995 Jan; 21(1): 95-102. (20 ref)

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Vachtenheim-J: [Non-steroidal antirheumatic ointments in the treatment of primary periarticular and intramuscular fibrositis]. Vnitr-Lek. 1995 Sep; 41(9): 609-12.

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