What’s known about fibromyalgia is that it causes severe pain and other serious symptoms. What's not known is how. The mechanism by which it causes you to suffer remains elusive.
Typical symptoms include muscle aches anywhere in the body, and can be in particular locations or spread out. The symptoms usually develop gradually but can also seem to come out of nowhere. Often, they come and go in highly individualized patterns.
If you have fibromyalgia, you know the pain is often maddening and attempts at relief are frustrating.
There has been relief reported in an approach that covers a wide range of possible triggers and symptoms. This holistic, or “whole person,” concept takes in both physical and psychological symptoms and treats them together. Such wide ranging treatment for fibromyalgia (and chronic fatigue syndrome) is also known as autogenic training, which involves verbal cues that can help you relax your body and learn to relieve pain.
“Persistent and recalcitrant conditions such as (fibromyalgia pain syndrome) can best be understood from a biopsychosocial perspective, since (it) is multifactorial in nature and involves many complex variables,” writes Micah R. Sadigh, PhD, author of the widely referenced book “Autogenic Training.”
Such seemingly mysterious conditions, he adds, “require a multi-disciplinary approach that focuses on coping mechanisms and symptom management.”
“The traditional medical model with its focus on microorganismic and pathophysiological concepts is too limiting…,” Sadigh writes.
About 5 million Americans age 18 or older have fibromyalgia, and a disproportionate number are women – between 80 and 90 percent. But men and children have it, too. If you have it, you were most likely diagnosed in middle age, although that can vary as well.
Women generally experience the pain anywhere and everywhere in the body. Men generally have localized symptoms, such as pain in a specific part of the back.
Fibromyalgia is considered a rheumatic condition because it impairs joints or soft tissues and causes chronic pain but, unlike arthritis, it does not cause inflammation or damage to your joints, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NAIMS).
In your case, it may be triggered by a stressful physical or emotional event. Sometimes it’s connected to repetitive injuries, sometimes to an illness, says the NAIMS.
A mind-body approach may include directed exercise, strength training, massage, and acupuncture. Meditative movement therapy used includes Tai chi, Qigong, yoga, and balneotherapy (spa therapy.) Hypnosis also has been used in many cases.
Treatment might also involve improving your sleep habits, cognitive therapy, and mineral and vitamin supplements.
“Doctors diagnose fibromyalgia based on all the patient’s relevant symptoms (what you feel), no longer just on the number of tender places during an examination,” according to the American College of Rheumatology (ACR).
The ACR claims that the “most effective treatment” for the condition is physical exercise, particularly aerobic exercise like walking. It agrees that other body-based therapies such as Tai chi and yoga can also relieve symptoms.
“Cognitive behavioral therapy (CBT) is a type of therapy focused on understanding how thoughts and behaviors affect pain and other symptoms,” the ACA adds. “CBT and related treatments such as mindfulness can help patients learn symptom reduction skills that lessen pain.”
It does caution that complementary and alternative therapies, such as acupuncture, chiropractic, and massage, “have not been well-tested in patients with fibromyalgia.”
You would be well-served to take an open-minded and open-ended approach to relieving your pain. Doctors who treat fibromyalgia in many patients believe the condition is different from one person to the next and is caused by a different combination of triggers as well.
“Treatment for fibromyalgia requires a comprehensive approach where we target all of the symptoms that occur on a persistent daily basis for any given patient,” said Julie Chen, MD.
“That would include addressing issues such as, but are not limited to, sleep, mood, chronic pain, fatigue, thyroid dysfunction, adrenal dysfunction, gastroenterological symptoms, and chronic headaches.”
Chen, who is board-certified in integrative and internal medicine, says the basis of her treatment for fibromyalgia includes acupuncture, soft tissue therapy, sleep counseling,
nutritional counseling, mind-body therapy types “that resonate with a patient,” and supplements.
February 23, 2016
Christopher Nystuen, MD, MBA