• WHAT IS FIBROMYALGIA SYNDROME (FMS)?
• SYMPTOMS AND ASSOCIATED SYNDROMES
• COMMON REMEDIES
• CHRONIC FATIGUE AND FIBROMYALGIA THERAPY
• TAKE RESPONSIBILITY FOR YOUR BODY
• LEARNING TO DIFFERENCIATE BETWEEN FIBROMYALGIA AND CRONIC MYOFASCIAL PAIN SYNDROME

WHAT IS FIBROMYALGIA SYNDROME (FMS)?

Fibromyalgia syndrome (FMS) is an often debilitating condition of chronic muscular pain and fatigue suffered by an estimated 2-4% of Americans and Canadians. Fibromyalgia is believed to afflict approximately ten million humans. (FMS) is an under diagnosed disorder of unknown etiology affecting over 5% of the clients in a general medical practise (Campbell 1983) and an estimated 2-4% of the general population (Wolfe 1993), women more often than men. Clients complain that they ache all over. A large number of other symptoms are often present, particularly fatigue, morning stiffness, sleep disturbance, paresthesias, and headaches.

In 1990, the American College of Rheumatology identified specific criteria for fibromyalgia. For a diagnosis of fibromyalgia, at least 11 of 18 specific areas of the physical body are required to be painful under pressure. Also, there is required to been a widespread pain in all four quadrants of the body lasting at least 3 months.

Fibromyalgia simply means pain in the muscles, ligaments and tendons, the fibrous tissues in the body. FMS (fibromyalgia syndrome) is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Fibromyalgia means pain in the muscles, ligaments and tendons, the fibrous tissues in the body. FMS was once referred to as fibrositis, implying that there was inflammation in the muscles, though research later proved that inflammation did not exist.

Fibromyalgia is capable of causing pain, from mild to agonizing, in many areas of the body and is capable of travelling from one area to another for no apparent reason. Some clients report pain and numbness in their arms and legs as well. It is capable of being a very frustrating condition, for both the sufferer and their loved ones. Our most important piece of advice is that a human with this condition, not give up, and believe that relief is possible if they make the commitment to themself and their deemed treatment.

While most of the humans effected by (FMS) are women between 29 to 50 years of age, (Ten to twenty percent of those with FMS are severely debilitated) Fibromyalgia is capable of happening to anyone of any age and often runs in families (similar to chronic fatigue syndrome and migraine headache)

Fibromyalgia, also known as fibromyositis and myofascial pain syndrome, refers to a chronic condition of unknown cause resulting in pain in the fibrous tissues, muscles, ligaments and tendons. In fact, most "experts" consider fibromyalgia and chronic fatigue syndrome to be the same condition.

SYMPTOMS AND ASSOCIATED SYNDROMES

Pain - The pain of fibromyalgia does not have any boundaries. Humans describe the pain as deep muscular aching, burning, throbbing, shooting and stabbing. Quite often, the pain and stiffness are more severe in the morning and there may be more pain in muscle groups that are used repetitively.

Fatigue - This symptom is capable of being mild in some clients and yet incapacitating in others. The fatigue has been described as "brain fatigue" in which patients feel totally drained of energy. Many clientss depict this situation by saying that they feel as though their arms and legs are tied to concrete blocks, and they have difficulty concentrating.

Sleep disorder - Most fibromyalgia clients have an associated sleep disorder that has been named the alpha-EEG anomaly. This condition was uncovered in a sleep lab with the aid of a machine which recorded the brain waves of clients during sleep. Researchers found that fibromyalgia syndrome clients were capable of falling asleep without much trouble, though their deep level (or stage 4) sleep was constantly interrupted by bursts of awake-like brain activity. Clients appeared to spend the night with one foot in sleep and the other one out of it. It ought to be noted that most clients diagnosed with chronic fatigue syndrome have the same alpha-EEG sleep pattern and some fibromyalgia-diagnosed clients have been found to have other sleep disorders, such as sleep myoclonus or PLMS (nighttime jerking of the arms and legs), restless leg syndrome and bruxism (teeth grinding). The sleep pattern for clinically depressed patients is distinctly different from that found in FMS or CFS.

Irritable Bowel Syndrome - Constipation, diarrhea, frequent abdominal pain, abdominal gas and nausea represent symptoms frequently found in roughly 40% to 70% of fibromyalgia clients.

Chronic headaches - Recurrent migraine or tension-type headaches are seen in about 50% of fibromyalgia clients and are capable of posing as a major problem in coping for this client group.

Temporomandibular Joint Dysfunction Syndrome - This syndrome, sometimes referred to as TMJD, causes tremendous face and head pain in one quarter of FMS clients. However, a 1997 report indicates that as many as 90% of fibromyalgia clients may have jaw and facial tenderness that is capable of producing, at least intermittently, symptoms of TMJD. Most of the problems associated with this condition are thought to be related to the muscles and ligaments surrounding the joint and not necessarily the joint itself.

Multiple Chemical Sensitivity Syndrome - Sensitivities to odors, noise, bright lights, medications and various foods is common in roughly 50% of FMS or CFS clients.

Other common symptoms - Painful menstrual periods (dysmenorrhea), chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling sensations, muscle twitching, irritable bladder, the feeling of swollen extremities, skin sensitivities, dry eyes and mouth, frequent changes in eye prescription, dizziness, and impaired coordination are capable of occuring.

Although the cause of fibromyalgia is unknown, there are many explanations for what occurs in the nervous system of people afflicted with fibromyalgia. Specific to this are the various reasons for the intense perception of pain. A change to the myofascia surrounding the muscles has been found to be one of the leading causes of pain and other muscular symptoms of fibromyalgia in the majority of cases. Myofascia is the thin, whitish membrane comprised of a material reffered to as 'ground substance' that envelopes and protects the muscle like a sack and which is responsible for supporting and connecting all of the body's muscles together. Normally, neurotransmitters pass easily from the interneurons on one side of the myofascia to create action potentials in the motor neurons attached to the muscles. In the case of people with fibromyalgia, however, often the myofascia has lost its elastic properties and hardened. The ground substance within the myofascia, which is usual in a fluid state, has become more like a solid gel. This change in the myofascia hinders or entirely prevents the neurotransmitters from reaching the motor neurons and creating action potentials.

COMMON REMEDIES

Western Remedies:
Presently, there is not a western medical cure for FMS. Traditional remedies are geared toward improving the quality of sleep, as well as reducing pain. For the reason that deep level (stage 4) sleep is so crucial for many body functions, such as tissue repair, antibody production, and perhaps even the regulation of various neurotransmitters, hormones and immune system chemicals, the sleep disorders that frequently occur in fibromyalgia and chronic fatigue clients are thought to be a major contributing factor to the symptoms of this condition.

Traditional western medical treatments try to improve the quality of sleep and reduce pain. Physicians may prescribe medications that boost the body's level of serotonin and norepinephrine, such as Elavil, Flexeril, Sinequan, Paxil and Xanax. NSAIDS such as ibuprofen may be helpful. However, if someone is taking medications every day for FMS, they may experience unpleasant side effects from the medicine that add to the misery of their fibromyalgia.

Chinese Remedies:
Chinese medicine views Fibromyalgia as a condition resulting from general weakness of the liver, kidney, spleen and heart, caused by "emotional" stress, over strain, lack of adequate sleep and nutrition, and disturbed body rhythm, in other words, the body is out of "synch."

Each client is assessed as to what imbalances are present. There are a number of different patterns for each individual client with FMS and the remedy ought to be tailored to each client's pattern. Acupuncture or acupressure and Chinese herbal medicine are capable of assisting to control the pain, increase energy and improve sleep and other symptoms. Fibromyalgia symptoms are greatly influenced by stress, amount of activity, and environment.

While western medicine doesn't have a treatment for FMS, Traditional Chinese Medicine has a diagnosis and treatment for your individual sets of symptoms. You may want to seek health care treatment from a Doctor of Traditional Chinese Medicine. Treatments include acupuncture, acupressure, tuina, and herbs, as well as other acceptable treatments based on your diagnosis. Chinese medicine differs from western medicine in that western medicine regards the body as chemical in nature, and therefore illness is treated with medication that changes the body's chemistry. Chinese medicine believes the body is energy.

CHRONIC FATIGUE AND FIBROMYALGIA THERAPY

We believe that when there is a combination of a varity of these modalities:

Acupuncture Chinese
Bodywork
Herbal Medicine
Biofeedback
Exercise
Foot Reflexology
Counseling
Spirituality
Spiritual Growth,
Changing whatever you are allowing to cause you to create stress in your life

About 70%-80% of the clients will experience marked improvement (decreased chronic fatigue and fibromyalgia symptoms), and 50% will be completely healed. This is not an instantaneous process, though we perceive that there will be significant improvement within 4-6 months.

Keep in mind that there are very few health care practitioners anywhere who've had success dealing with this complex illness.

TAKE RESPONSIBILITY FOR YOUR BODY

Remember to make the following a part of your daily life, similar to brushing your teeth or eating breakfast. They are daily commitments that will greatly help not only your symptoms, though with your overall health and well-being:

• Exercise daily-push yourself enough to stimulate your heart rate and warm your muscles, though not so much that you sense an overtiredness or soreness the next day.
• It is important to keep moving, even though exercise is the last thing you might perceive doing. Gentle exercise such as walking, yoga and Tai Chi keep you flexible and build strength. Also, be aware of your posture as you go about your daily activities.
• Promote circulation to aching or tired muscles with electrotherapy stimulation.
• Drink plenty of water, at least 8 glasses a day. Limit consumption before bedtime, however, to avoid being awakened by a full bladder.
• Allow yourself to receive plenty of rest. Even if you have insomnia (as most Fibromyalgia clients do), make sure you relax and adopt habits to quiet your mind, such as meditation or a soothing bath.
• Balance your life. On favourable days, do not do too much. On non favourable days, do not do too little. Decide what you require to do and what you want to accomplish to have a favourable day that includes personal care and exercise, house and yard work, enjoyable activities and hobbies, social time and relaxation. Time management skills are important, so you will be capable of having the most favourable day possible.
• Eat healthy foods. Avoid any that seem to degenerate your symptoms (many people report that sugar, for example, contributes to their pain). Avoid all sources of caffeine and alcohol, which are capable of inhibiting sleep.
• Avoid any extremes, including temperatures in environment and the foods and beverages you consume. Do not do too much or too little of anything.
• Do gentle stretching every day to keep muscles loose and out of their contracted state. And remember that stretching works clearest when your muscles are warm, such as after a bath, exercise or stimulation therapy. Do not ever stretch beyond your limits-remember resistance, not pain.

LEARNING TO DIFFERENCIATE BETWEEN FIBROMYALGIA AND CRONIC MYOFASCIAL PAIN SYNDROME

Fibromyalgia and chronic fatigue syndrome (CFS) share a number of symptoms, and the names are often used interchangeably in the medical literature. While it is possible to have both fibromyalgia and myofascial pain, there are definite differences. One difference is that more women than men have fibromyalgia, though the ratio of men to women who have myofascial pain syndrome is equal. Also, in fibromyalgia, the muscles have generalised sensitivity, while with myofascial pain, the muscle areas that are located away from the trigger points and their referral regions have normal sensitivity. With fibromyalgia, there is total body achiness, while with myofascial pain there are specific pains in specific areas. With myofascial pain, the areas not affected by trigger points do not hurt, though with fibromyalgia, the areas outside the tender points still ache. Fibromyalgia is a neuroendocrine disorder while myofascial pain is a neuromuscular condition.

Research shows that between 50 percent and 70 percent of humans with fibromyalgia also fit the criteria for CFS, and vice versa. For the reason that the symptoms are so similar, the difference between one diagnosis and another may be simply a matter of degree.

The diagnosis also may depend on whether your doctor is more familiar with the criteria for CFS, developed by the Centers for Disease Control and Prevention (CDC) or those for fibromyalgia, developed by the American College of Rheumatology.

There are a few documented differences between the conditions.

• Fibromyalgia often is traced to an injury or physical or emotional trauma, whereas CFS tends to have a flu-like onset.
• Researchers have found that people with fibromyalgia may have abnormal levels of several chemicals, such as substance P and serotonin, used by the body to transmit and respond to pain signals.
• Also, people with CFS only do not have tender points.
• There is some evidence that graded aerobic exercise improves muscle function and reduces pain in FMS though exercise is often impossible for, and may even hinder, CFS patients.

Sleep disturbances occur with both conditions for the reason that attempting to sleep when one is in pain is very difficult, plus living with any type of chronic pain is capable of leading to a non hormonal depression. In both cases, at least part of the fatigue, and usually the largest part, is due to lack of restorative sleep. In fibromyalgia, this is due to the neuroendocrine imbalance, and in myofascial it is due to the pain.

Humans with only chronic myofascial pain are capable of improving and are capable of returning to what is deemed of as normal life with treatment and control over their perpetuating factors, though those with a true diagnosis of fibromyalgia do not have a specific treatment plan available that works for every one of them at this time.

As a result of the relatively recent introduction of fibromyalgia as a valid medical syndrome and diagnosis, much is known about what occurs inside the body and the nervous system with fibromyalgia, but very little is known about the exact cause or causes or, most unfortunately, an effective curein western medicine.

Now that we have written all of this, Fibromyalgia is not really a syndrome. Fibromyalgia and its sister labels (fibrositis, chronic fatigue syndrome, etc.) are systems of belief and not unique as such. It is just that in the modern United States of America so many belief systems are camouflaged by a patina of unfounded "science." Science is not capable of ever proving a belief system. It is only capable of only assaulting its tenets, test its predictions, and mobilise confidence that it is not a clear action to take. For fibromyalgia, the tenets have been shown to be flawed, repeatedly. And in defiance of the predictions, clients are not advantaged. They are left to suffer while they await the pathophysiologic insight that is promised and that will justify their waiting and validate their suffering. Fibromyalgia is a belief system that has been scorned by the medical establishment for nearly a century.

Sources:

1. Fibromyalgia. Arthritis Today Online
   Arthritis Foundation.
   Accessed April 9, 2002.
2. Fibromyalgia. What Is It?
   Arthritis Foundation.
   Accessed April 9, 2002.
3. Fibromyalgia. What Is Fibromyalgia? OHSU Health
   Oregon Health Sciences University. 2002.
   Accessed April 9, 2002.