Resolving Fibromyalgia – Perspective of a Naturopathic Doctor
Rahim Habib, Naturopathic Doctor
“The pain is so bad I feel like I got hit by a truck!” “When I wake up each morning, I’m more tired than when I went to sleep!” “It feels like I walk through knee-high mud everyday.” These are the words of patients I have seen who have a chronic pain condition called fibromyalgia. Most people have experienced some level of pain in their lives, however, those who have fibromyalgia (aka fibrositis, fibromyositis) experience it on a persistent, daily, and often intense level.
The standard medical treatments include using pain medications, muscle relaxants, anti-depressants, exercise and cognitive therapy. Unfortunately, these standard treatments often fall short in terms of any significant or long lasting improvement, and people with fibromyalgia often end up living difficult lives, or seek other or combined solutions.
What Is the Cause of Fibromyalgia?
From my 10+ years of experience as a naturopathic doctor in helping people with fibromyalgia, the causes are often multi-factorial, from a combination of factors, as discussed in detail below, followed by naturopathic treatment options.
Accidents/Injuries & Work Related Strain
Between 25-50% of people with fibromyalgia had a traumatic accident or injury weeks or months before the symptoms began. It intuitively makes sense that a pain syndrome like fibromyalgia could be associated with an accident, though the research is inconclusive. However, I have observed in my patients with fibromyalgia, that physical, chemical, or emotional traumas are associated with fibromyalgia. Fibromyalgia has also been found to start after work-related stresses, including repetitive strain injuries (RSI), have occurred from the workplace.
“Stress” is a term that can be widely applied and defined. In this article it refers to the cumulative load of family and work responsibilities, commitments, and poor coping techniques, etc, which burden a person beyond what their body and mind can handle. Once this personal stress ‘threshold’ is passed, symptoms and signs of fibromyalgia can begin: it may be more aches and pains with performing simple and light tasks, and often spreads to include more daily tasks and areas of the body that would not have felt pain in the past. Some say stress really means that “the problem is in your head/mind” – however, there is a reality to pain that is both subjective and individual, and is something that has a deep underlying sense of reality, which holds people back from fully living their lives. As with cases of fibromyalgia that come after an accident, other stresses such as chronic inflammatory illnesses – which is a significant source of stress – can precede the overt fibromyalgia symptoms.
It is common that we show a “brave face” to the world – both to society in general, and in our work and home lives. We are subtly expected to be independent and not to show weakness. However, this is a stress coping style which is doomed to fail for a person’s body and mind. This approach to handling our emotional challenges can lead to loneliness, resignation from the world, poor communication skills, a distorted sense of self and community, and sometimes arrogance and eventually anxiety or depression. The body then has to deal with these emotional stresses in some way, and if it is not in the form of effective communication and expression, then, in the case of fibromyalgia, it places this strain on the body’s own tissues, like a form of auto-immunity; it gets ‘buried under the body’s rug’ so to speak, as a physical pain.
Most fibromyalgia sufferers have some form of sleep disturbance. Some researchers think this may even be the cause of fibromyalgia, whereas others think it is part of the manifestation of the illness. Common sleep problems include periodic limb movements (PLM) during sleep, restless leg syndrome (RLS), central sleep apnea, and excessive alpha-wave sleep patterns.
Infections, Vaccinations, and Dysfunctional Immune Reactions
German researchers from a study in 2009 have found that those who suffer from the chronic forms of Lyme Disease (due to the bug-bite transmitted bacteria Borrelia burgdorferi) have very similar symptoms as those with fibromyalgia, and they may be related. People with Hepatitis C, HIV, and XMRV viruses show some associations to the development of fibromyalgia. There are also theories that multiple-vaccinations can serve as a co-trigger of fibromyalgia in an environment of stress and trauma, as seen in soldiers with ‘Gulf War Syndrome’.
Free radical damage/oxidative stress in muscle
Those with fibromyalgia tend to have less antioxidant protective factors in their blood (‘antioxidants’ are substances that protect the body’s cells, just as lemon juice protects a cut apple surface from browning) . A deficiency of antioxidants is called “oxidative stress” (like ‘rust’ inside the body) which can lead to dysfunction of cells in the body. A 2009 Turkish research study found that people with fibromyalgia specifically had significantly lower levels of glutathione (a cellular antioxidant and detoxifying substance that the body makes) and catalase, compared to healthy people in the study.
Chemical toxins inhibit the natural functions of the various tissues in the body. One of the most sensitive types of tissues is the nerves, or the neurological tissues/system. Toxins can also reach the insides of the cells, inhibiting how the cells even make their energy. Sometimes part of the problem is the slow elimination of the toxins – that is, when our digestive functions are slow, or if our lymphatic system (the body’s waste management system) is blocked. Neurotoxins are particularly suspected in the case of fibromyalgia and can include mercury, arsenic, lead, and solvent chemicals.
Fibromyalgia & Diet – Poor Nutrition
Without the right levels of vitamins, minerals, proteins, fats, carbohydrates, water, and other healing factors produced by the body, our body is not able to structurally heal itself, or to allow for normal functions. Whether it is the immune system, the neurological system, or other systems, our normal functions then slow down or get stuck – like a construction worker without enough supplies – the job comes to a stand-still.
In addition, when the body is malnourished, toxins have the most devastating impact on the body – it’s like a double whammy – low nutrients slow the construction work, but toxins make the job-site unsafe.
Glandular Imbalances & Organ Weaknesses
Glands that tend to be weaker in people with fibromyalgia include the adrenal glands, the pituitary gland, the hypothalamus gland, and others. These are often related to the effect of stressors. Organs such as the digestive tract and the liver and gall bladder can also be low functioning for a variety of reasons: antibiotic-related imbalances, overwhelming toxicity load on the liver, and low fiber and water intake in the diet.
Some people develop weak livers due to poor genetics, which can mean more susceptibility to toxins, and a greater demand on optimal nutrition and other supports. Blood tests will indicate whether genetics plays a role in developing fibromyalgia. If so, there are ways to adjust the genetic expression, and possibly help control symptoms of fibromyalgia.
Food intolerance means that there is a negative reaction to certain foods. In the case of fibromyalgia, these foods can aggravate their pain levels. This may also relate to their general digestive strength and liver function. Read more on this in the therapy section below.
Studies have shown that many people with fibromyalgia have reduced blood flow to the front part of their brain. This may explain why some sufferers of fibromyalgia have a ‘foggy’ head sensation, where they find it difficult to think or concentrate. In a different way, these people may also be’ sensitive’ to certain chemicals (eg: petro-chemicals, solvents, perfumes, etc.) that can damage their nerve system.
There is no doubt that there is an underlying neurological sensitivity combined with one or a few triggers and aggravating factors in the causation of fibromyalgia. Often sleep is disturbed, digestive functions can be difficult, and overall vitality is quite low. In most cases, a comprehensive plan is required to significantly help people with fibromyalgia.
The Role of a Naturopathic Doctor
As a registered naturopathic doctor, I am trained to help determine the cause(s) of health issues and the aggravating factors. This usually involves testing for different levels of imbalance: nutrition, body-composition, toxicity, level of free radicals, stress factors, food relationships, etc. An important and often neglected area of assessment and treatment is the connection of the mind and emotions with the physical state of the body. We are truly one being, made up of different, though integrated levels; they work or do not work together and I find that true balance and restoration of function comes from integrating the mind and body together.
A recent research study that shows the benefit of an integrated approach was conducted in 2011. The Spanish research study published in the journal Rheumatology International, found that an integrated or multidisciplinary program showed significant improvement in people with severe fibromyalgia compared to a different fibromyalgia group (also severe) who only did the standard medical treatment. It was an 8-week program, of 1 hour per week of massage, tender point treatment, thermal therapy, and aerobic exercise. In my naturopathic practice, I offer a similar program that also integrates a nutritional component, balneotherapy (a mineral-rich form of hydrotherapy), as well as working at the level of mental-emotional stressors. I have found that my patients with fibromyalgia have less tender points, improved breathing, greater stamina, and mental-emotional balance.
Naturopathic Treatments for Fibromyalgia
Treatments will vary depending on the causes. Below is a list of some useful treatments that can reduce the symptoms of fibromyalgia, and in the correct combination, can help resolve the fibromyalgia.
Circulation, Physical Therapies, and Exercise
There is no doubt that there are improvements in people with fibromyalgia with graded exercise programs. Many people with fibromyalgia have reduced blood flow to parts of their brain that control sleep, pain signal processing, temperature control, cognitive function, etc. So it is no wonder that improving circulation helps. As a naturopathic doctor, I have found that starting with gentler forms of activity can promote circulation and accelerate symptom improvement: far-infrared sauna, whole-body-vibration therapy, or even balneotherapy. Later, we introduce more active aerobic exercise (this helps avoid exercise-induced setbacks). In a 2011 research study published in the Journal of Back and Musculoskeletal Rehabilitation, a combination of standard physical therapy with balneotherapy resulted in the best improvements in breathing for those suffering from fibromyalgia. Balneotherapy has also shown to improve the levels of inflammation in fibromyalgia sufferers, and in actual perceived levels of tenderness and pain.
Fibromyalgia Diet, Nutrition, Antioxidants
Most people will feel better if they eat better, this is also true of people who suffer the pain of fibromyalgia. In addition, when the most common irritating foods are removed from the diet, known as an ‘elimination diet’ (eg: removing foods such as wheat, dairy, sweets, processed foods, etc.) even better results can be felt. Washington USA researchers published a 2011 study showing that fibromyalgia patients who followed an elimination diet which also included a nutrient-rich hypoallergenic medial food, there was a significant decrease in the level of pain and stiffness, and an increased pain tolerance. In a study conducted on people with fibromyalgia who previously did not improve with standard medical treatments, intravenous nutrients (‘modified Myers Cocktail’) were supplied each week for eight weeks. By the end of the study, the level of pain had reduced by 60%, and the energy level improved by 80%. Other studies on intravenous micronutrient therapy (IVMT) have shown lowered levels of depression and improvement in the quality of life after treatment.
Research has also shown that specific supplements can help improve the symptoms of fibromyalgia: magnesium, s-adenosyl methionine, carnitine, ribose, 5-HTP, specific B-vitamins, and melatonin. These supplements often work best when integrated in a planned holistic approach which addresses the underlying causes of fibromyalgia.
Fibromyalgia & Detoxification & Cleansing
The identification and removal of toxic elements is beneficial for most people. For those with fibromyalgia, it can also be helpful. It is important however to first address any nutritional deficiencies and ensure proper organ functions before a cleansing regimen begins. Studies have shown that when a hypoallergenic and nutritionally balanced diet is provided, and with extra supplemental supports are put in place, the detoxification or the elimination of neurotoxins such as mercury and arsenic occurs, and this correlates with improved fibromyalgia symptoms.
Mental-Emotional Balance, Stress Management, and Mind-Body Medicine
There is no doubt that when fibromyalgia sufferers are able to better handle and interpret their stressors, they are better able to cope with their pain and have a better state of health overall; this exemplifies the benefits of cognitive-behavioural therapy. In addition, other useful methods such as meditation, and essential oil based facilitated techniques can help to help fibromyalgia sufferers to self-regulate their pain and other symptoms. In my naturopathic practice, I always work on the mental-emotional level with my patients with fibromyalgia, since it directly connects to the body. I use “mind-body medicine” sessions to explore the connections and causes of the pain, and together we unravel the associations, and in most cases disconnect the pain from the mental & emotional burden these patients face on a daily basis.
The use of a uniquely prescribed low dilution medicine, or homeopathic medicine, has been found to be helpful in many research studies on those with fibromyalgia. I have found that after a detailed consultation, a specific homeopathic medicine can help control the particular forms of pain that patients with fibromyalgia can experience. Whether the pain is sharp, achey, shooting, or throbbing, these can all lead to recommendation of unique, dilute homeopathic medicines that fit the individual experience of each individual person with fibromyalgia.
In summary, as this naturopathic review article states, there is a strong role that naturopathic medicine can provide in helping people who have fibromyalgia, so that they can live functional and productive lives.
Rahim Habib ND
Four Seasons Naturopathic Clinic
305 Carrville Rd
Richmond Hill, Ontario CANADA