Disease of The Month.

August 1998.

FIBROMYALGIA


I am writing about this disease symptomology at the request of a visitor to The Alchemycal Pages. I obtained the following information from a website which no longer exists.
Fibromyalgia syndrome (also called "FMS" or "FM" ) is a complex, chronic condition which causes widespread pain and profound fatigue, as well as a variety of other symptoms. Its effects are felt primarily in muscles, tendons, and ligaments throughout the body. Unlike arthritis, however, no inflammation accompanies fibromyalgia, and the joints of t he body are not directly affected.
The pain of fibromyalgia syndrome is usually described as aching or burning and is unpredictable in nature. Its severity varies from day to day, and different parts of the body tend to be affected at different times. In some people, FMS pain can be very severe and disabling, while in others it may cause only mild discomfort.
Likewise, the fatigue which often accompanies fibromyalgia syndrome ranges from a mild, tired feeling to all-consuming exhaustion.
Fibromyalgia Tender Points:
NOTE - Search for illustrations of these points online. The site I used is no longer active. I have checked these points against the pathways of acupuncture meridians on a meridian chart and (as near as I can determine, anyway!), I have noted on which organ meridians these points lie.
Identified by the American College of Rheumatology in 1990, at digital palpation with an approximate force of 4kg.
1 & 2,Occiput: bilateral, at the suboccipital muscle insertions. Gall Bladder
3 & 4, Low cervical:bilateral, at the anterior aspects of the intertransverse spaces at C5-C7. Large Intestine
5 & 6, Trapezius: bilateral, at the midpoint of the upper border. Gall Bladder
7 & 8, Supraspinatus: bilateral, at origins, above the scapula spine near the medial border. Bladder
9 & 10, Second Rib: bilateral, at the second costochondral junctions, just lateral to the junctions on upper surfaces. Kidney
11 & 12, Lateral epicondyle: bilateral, 2cm distal to the epicondyles. Large Intestine
13 & 14, Gluteal: bilateral, in upper outer quadrant of buttocks in anteriorfold of muscle.
15 & 16, Greater trochanter: bilateral, posterior to the trochanteric prominence. Bladder
17 & 18, Knee: bilateral, at the medial fat pad proximal to the joint line. Spleen

Symptoms: In addition to pain and fatigue, individuals with FMS usually experience some of the following:
Sleep Disturbance: Despite getting adequate amounts of sleep, FMS patients may awaken feeling unrefreshed, as if they've barely slept at all. They may also have difficulty falling asleep or staying asleep.
Stiffness: Body stiffness is a significant problem experienced by most patients. It can occur upon awakening or remaining in one position for prolonged periods. It can also accompany weather changes.
Increased Headaches or Facial Pain: Headaches are a common complaint for many with FMS. They may be caused by referred pain from tender neck and shoulder areas, or they may be associated with pain in the muscles and other soft tissues around the temporomandibular joint, or TMJ, which is located where the jaw meets the ear. In the latter case, jaw or facial pain is usually present, too.
Abdominal Discomfort: FMS-related symptoms include digestive disturbances, abdominal pain and bloating, constipation, and diarrhea. As a whole, such symptoms are known as irritable bowel syndrome.
Irritable Bladder: Fibromyalgia patients may notice an increase in urinary frequency or experience a greater urgency to urinate. Often, no accompanying bladder infection is present.
Numbness or Tingling: Also known as "paresthesia", symptoms usually involve a prickling or burning sensation, particularly in the extremities.
Chest Pain: Persons with FMS sometimes experience a condition called "costochondralgia" which involves muscular pain at the spot where the ribs meet the chest bone. Since costochondralgia mimics cardiac symptoms, it is always a good idea to check with a physician if chest pain occurs.
Cognitive Disorders: Frequent complaints, which vary from day to day, include difficulty concentrating, "spaciness", memory lapses, word mix-ups when speaking or writing, and clumsiness or dropping things.
Dysequilibrium: FMS patients may also experience dizziness and balance problems. Typically, there is no classical, spinning vertigo. Rather difficulties in orientation occur when standing, driving, or reading.
Environmental Sensitivity: Allergic-like reactions to a variety of substances are common, as are sensitivities to light, noise, odors, and weather patterns. Dryness of the skin, eyes, and mouth is also common.
Other Symptoms: Increasingly, additional symptoms and syndromes are being associated with FMS. These are discussed in more detail in publications and audiotapes produced or sold by the Fibromyalgia Association of Greater Washington, Inc. (FMAGW).
Diagnosis
Currently, no diagnostic, laboratory test exists for FMS. For fibromyalgia to be diagnosed, other conditions that mimic its symptoms must first be excluded (i.e., thyroid disease, lupus, lyme disease, rheumatoid arthritis, etc.). Furthermore, according to official, diagnostic criteria established by the American College of Rheumatology, a patient must suffer from widespread pain in all four body quadrants for at least three months. Finally, 11 of 18 possible tender points should be present when specific locations in the neck, shoulders, chest, hip, knee, and elbow regions of the body are examined by a physician (see diagram at right), although patients may not be aware that these tender points exist. Some physicians take the position that less than 11 tender points can be present at any given time for a fibromyalgia diagnosis to be made.
Rheumatologists and physiatrists (specialists in physical medicine and rehabilitation) are often the most knowledgeable when it comes to diagnosing FMS.
Treatment
To date, there is no cure for FMS. Treatment consists of managing symptoms to the greatest extent possible. Because patients vary widely in their responses to available modalities, several approaches may need to be tried before a satisfactory regimen can be established. For this reason, a multi-disciplinary, medical team approach is beneficial. The following treatments, used alone or in combination, generally help patients feel better and improve their quality of life:
Medication: For pain relief and improved sleep, medicines which increase the body's level of serotonin (a chemical in the brain that regulates pain and sleep) are often prescribed in low doses. In addition, non-steroidal, anti-inflammatory drugs (i.e., ibuprofen, aspirin) can also be helpful. There are new drugs now available targeted to this condition.Specific medicines which treat other symptoms (like abdominal or allergic complaints) may also be required.
Physical Therapy: Among the many types of available approaches are: massage, myofascial release, cranio-sacral therapy, mild electrical stimulation, the application of heat (i.e., moist heat packs, hot baths or showers), the application of cold/ice packs, ultrasound, posture and movement training, and chiropractic.
Exercise: Gentle exercise can often be helpful in easing sore muscles by increasing blood circulation and range of motion. Medical practitioners usually prescribe stretching and low-impact exercise (i.e., water exercise in an 85 degree heated pool, walking, treadmills or cross-country ski machines).
Alternative Approaches: Increasingly, fibromyalgia patients are finding some relief from such treatment modalities as biofeedback, yoga, tai chi, stress management, nutritional counseling, and acupuncture. Emotional support is also crucial to help individuals manage their perplexing array of symptoms and undertake necessary lifestyle changes. Support can be obtained informally from fibromyalgia self-help and support groups, clergy, family members, or friends. Professional assistance is also encouraged for those having a difficult time adjusting to life with fibromyalgia syndrome.
Cause
While researchers continue to seek the cause of fibromyalgia syndrome, there is evidence that FMS is triggered in pre-disposed individuals by such precipitants as illness, physical trauma to the body, or acute emotional stress. FMS also seems to run in some families, although no genetic component has yet been identified as of this time. Encouraging research is now occurring in the fields of neuroendocrinology, immunology, cardiology, and exercise physiology, among others.
So, what do you do if you have any or all of these symptoms? You go on a macrobiotic dietary program tailored to your physiognomy and constitution and do the regimen of ginger compresses on your abdomen.



Comments or questions can be sent to the address below as I check this address every few weeks. Please mention Alchemycal Pages in the subject line. Thank you. Patricia

kaare@mac.com
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