Alternative Ways to Treat Fibromyalgia
From Pain To Freedom
From Pain To Freedom is the Latest Scientific and Natural Medicine Breakthroughs to Understand and Relieve the Symptoms of Fibromyalgia!
Fibromyalgia syndrome (FMS) is a musculoskeletal disorder characterized by widespread pain for at least 3 months, with muscle and connective tissue stiffness. There is increased pain sensitivity to palpation of at least 11 out of 18 tender points throughout the body (e.g., back, neck, shoulders). FMS is pervasive, with 3-6 million Americans suffering from this disorder. Furthermore, FMS symptoms tend to be chronic in nature and resistant to medical treatment.
Women with fibromyalgia sometimes present with CPP. Two criteria must be present for diagnosing fibromyalgia The patient reports pain in all four quadrants of the body, and detection of at least 11 separate areas (eg, knees, shoulders, elbows, neck) that are tender to physical pressure. Fibromyalgia Depression Somatization Substance abuse
Overall, although only a limited number of well-controlled outcome studies are available (see Nezu et al., 2001), the available research does underscore the significant potential of CBT as an efficacious treatment approach for MUS and related functional disorders (i.e., chronic fatigue syndrome, fibromyalgia, and noncardiac chest pain). Specifically, CBT has demonstrated benefits in significantly improving the physical symptoms and psychological health of these patients.
Nonhormonally responsive diseases should be considered for pain that is not related to menses, including chronic pelvic inflammatory disease, adhesions inflammation from previous pelvic surgery, irritable bowel syndrome, diverticulitis, fibromyalgia, and interstitial cystitis.
Figure 3 A comparison of memory scores for patients with LE, fibromyalgia, and depression on the CVLT. LE Fibromyalgia Depression Figure 3 A comparison of memory scores for patients with LE, fibromyalgia, and depression on the CVLT. on memory impairment in LE patients, my colleagues and I compared 20 patients with well-documented Lyme disease to patients with fibromyalgia and patients with mild to moderate depression. The rationale for comparing fibromyalgia and depressed patients with LE patients was that the cognitive symptoms in these illnesses are similar. Thirteen of the 20 Lyme patients had abnormal CSF and 2 had abnormal MRI scans. Memory was assessed using the three standardized memory instruments the CVLT, the Wechsler Memory Scale (WMS), and the Rey-Osterrieth Complex Figure. Indices of psychopathol-ogy were obtained from the MMPI and BDI. The depression and fibromyalgia groups performed significantly better than the LE group on both the CVLT (Fig. 3) and a WMS visual memory...
FIBROMYALGIA AND CHRONIC MYOFASCIAL CHEST PAIN Fibromyalgia is classified by the American College of Rheumatology as the presence of 11 of 18 specific tender points, nonrestorative sleep, muscle stiffness, and generalized aching pain, with symptoms present longer than 3 months. 9 Chronic myofascial chest pain is classically a dull, constant pain associated with trigger points on the chest wall. Symptoms may mimic ischemic myocardial-type chest pain but usually is not provoked by exercise (unless the movement involves the use of chest or arm muscles) and is not completely relieved by rest.
Several clinically applicable handheld software programs have been described in the literature in recent years. Newman, Kenardy, Herman, and Barr Taylor in 1996 used a Casio PB-1000 handheld computer to prompt patients with panic four times per day to report anxiety levels and occurrence of panic attacks. During the client's office visit, data were uploaded to a desktop computer, stored in a database, and then analyzed. Reports were generated that summarized client responses to the computer. Others have recently reported using handheld devices to record frequency of smoking behavior, measure reaction time during a prolonged, simulated submarine crisis, measure stress reactions in the natural environment, and assess obsessive-compulsive, fibromyalgia, and dementia symptoms.
Biofeedback or applied psychophysiology (AP) has been most frequently used to assist in the attainment of a relaxed physiological and psychological state. Schwartz has labeled the many procedures aimed at accomplishing this task as cultivated low arousal.'' The paradigm driving these applications is based on the assumption that many disorders (often called functional disorders) in modern medicine are the result of the sympathetic nervous system and the hypotha-lamic-pituitary-adrenaline (HPA) system being driven to excessive levels over a long period of time. Disorders included in this list are many hypertension, headache, irritable bowel syndrome, back pain, asthma, noncardiac chest pain, fibromyalgia, chronic fatigue syndrome, temporomandibular disorder, and perhaps the somatic symptoms of anxiety disorders. Whereas the evidence related to etiology is mixed with regard to most of these disorders, the treatment protocols described next have been fairly successful in reducing or...
Women in whom a particular disease process is suspected, such as adenomyosis, uterine leiomyomata, irritable bowel syndrome, interstitial cystitis, diverticulitis, or fibromyalgia should undergo further diagnostic testing and disease-specific treatment.
A rather large number of NF practitioners are claiming significant improvement in clients diagnosed with chronic fatigue syndrome and in many diagnosed with fibromyalgia. Such reports have gained considerable attention because these disorders have proven difficult to treat through traditional medical procedures. Several years ago it was often reported that chronic fatigue syndrome was characterized by abnormally high amplitude EEG slow waves, especially at frontal sites, and NF treatment was designed to increase activation (raise b amplitude) at those sites. More recently, however, there seems to be disagreement among even experienced practitioners, who report that other abnormalities are common in chronic fatigue syndrome, including generalized EEG slowing, generally low EEG amplitudes, and unusual variability of brain electrical activity.
Complete eradication of pain is not a reasonable end point in most cases. Rather, the goal of therapy is pain reduction and return to functional status. Chronic pain syndromes discussed in this chapter include myofascial headaches, transformed migraine headaches, fibromyalgia, myofascial chest pain, back pain, complex regional pain types I and II, postherpetic neuralgia, and phantom limb pain. Drug-seeking patients are also covered.
Endometriosis is related to environmental contamination. Dioxin, one of the first pollutants scientists studied, is an example (see the sidebar Understanding dioxin exposure earlier in this chapter) of an environmental effect on endometriosis. Likewise, scientists can link pollutants to multiple sclerosis, lupus, thyroid disease, chronic fatigue syndrome, fibromyalgia, and even cancer.
The answer may lie in the immune system. The study of the immune system and its relation to endometriosis and other immune-related diseases (such as lupus, fibromyalgia, and chronic fatigue syndrome) has rapidly progressed in the last decade. The immune system does seem to play a role in endometriosis.
The understandable reluctance of many physicians to make formal somatoform diagnoses suggests that current data may underestimate the true prevalence of unexplained medical symptoms. In addition, many patients with diagnoses such as chronic fatigue syndrome, fibromyalgia, and noncardiac chest pain may be more appropriately viewed as having somatoform illness.
The majority of studies addressing outcome in somatoform illness have concentrated either on conversion disorder or on somatization disorder, and research explicitly addressing other forms of somatoform illness is rare. It is nevertheless likely that studies investigating the outcome of conditions such as chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, and chronic pain conditions are implicitly addressing other aspects of somatoform illness. A review of the substantial literature concerning these conditions is beyond the scope of this article.