Mystery illnesses: an in depth look at fibromyalgia

Update, part one

I first ran this series on Fibromyalgia in 1997. The first update appeared again one year later. Since that time the mailbox continues to fill with requests for more information on fibromyalgia (FM). '' I missed part two or part five and am desperately searchingŠ'' With my editors' permission I'm rerunning the series and will do my best to include any updated treatments available.

I recently spoke to a FM support group on the role of massage, nutrition and wellness in the treatment of FM. Some of the faces have changed but the look of pain and distress has not. The stories sound the same, yet each one is different. This is one of the most distressing problems for sufferers and doctors alike. Herein lies a clue. If everyone's symptoms are different, how can we expect the doctor to hand us a pill and expect that all will be well again? Instead we must begin to reclaim some responsibility for our ill health and it's underlying causes.

Let's look again at a typical FM scenario.

Sally enters the doctor's office, the fifth one she's seen in less than six months. She nervously sits down. Her emotions are running high. Confused and worried about the outcome of her visit, on the one hand she hopes the doctor will tell her nothing is wrong. On the other she hopes that all her aches and pains will finally have a name and that a medication will fix it.

She is here because her pain has become an unrelenting all over kind of ache that seems to be making life impossible. Nothing in her life seems to be working. She is hardly civil at work and more frequently finds herself losing it with her husband and the children. The trips to the gym, which she had thought were helping, have all but stopped. In fact it seems all unnecessary activities including things that might be fun have taken a back seat.

When the doctor is finally able to see her, and asks what is wrong, she begins with a list of problems that seems endless; blinding headaches, neck and shoulder pain, insomnia, dropping things, and an inability to concentrate. Before she's even finished talking the doctor is reaching for his prescription pad and writes not one but several scripts; anti-inflammatories, muscle relaxants, something for depression and sleep -- yikes!

She watches in horror as the doctor now turns to her chart and writes diagnosis: fibromyalgia, prognosis: fair. Sally has never heard the term fibromyalgia before. What does it mean? Will I ever be well again? And what does he mean prognosis: fair?

In the months to come since the medications are of only marginal help: she has a battery of blood tests; x-rays; MRI; and a procedure under general anesthesia. None of these exams reveal anything definitive and she is left feeling more depressed and powerless than ever.

If this sounds familiar, you may indeed have FM and you do need to see your doctor. For those of you who do have FM don't become offended, I know your aches and pains are real -- but what garbage can diagnosis.

To simply accept a diagnosis and give it a name does not help. In fact it may do just the opposite -- leaving the individual with feelings of helplessness that are so personally devastating they may never find their answers.

We have entered an age of chronic degenerative disease including the complex multi-system dis-ease known as fibromyalgia. Let's not dwell on a name but instead look at sound treatment for all those symptoms, one by one if necessary.

Next week I will explore some of the physiological changes going on in the body, address symptoms and talk about holistic therapies that bring pain relief, comfort and healing.

Till next time, Rebecca

Part two

Last week, in part one, I looked at the typical case scenario of Fibromyalgia (FM) from the standpoint of the patient. Because there are no current diagnostic or laboratory tests for the diagnosis of FM patients are left confused, misdiagnosed and struggling with medications that work only some of the time. No wonder they feel depressed.

Despite the newer name and the number of patients being diagnosed with this malady, FM is not a new disorder. The condition known as FM was first described in 1904 by Stockman and Gowers. The term was given to individuals suffering with myofascial (the muscles and their coverings) pain of unknown origin, questionable dysfunction and inconclusive diagnostic workups. Other diagnostic terms used to describe this diffuse pain syndrome that were just as ambiguous were fibrositis, myofascitis, muscular rheumatism, myogelosis, and myalgia.

Since the mid 1970’s rheumatologists and other clinicians have attempted to categorize myofascial pain into distinct syndromes, with specific criteria applying to each one. The specific criterion that describes and defines FM is as follows: A non-articular (non-joint related) rheumatic like disorder of unknown origin that is characterized by wide-spread musculoskeletal pain lasting at least three months. Other criteria include marked fatigue, disturbed sleep and a number of muscular tender points with very little restriction of movement.

Although there is no known cause of FM, the onset is many times related to periods of increased physical or mental stress, inadequate sleep, injury or infection. There are no known genetic links and women are more often affected.

If the condition is generalized enough, any organ system can be involved. This may indicate that the disease process has been going on long before the more obvious symptoms of pain.

The disturbing part for patient and doctor alike is the absence of laboratory and x-ray results indicating any other rheumatic diseases. The patient knows they are not making it all up and hopefully the doctor is taking their patient seriously. From the standpoint of traditional western medicine the doctor can only treat the symptoms and hope that things will resolve on their own. Unfortunately many times symptoms do not resolve with traditional medical intervention leaving the patient feeling as though there are few options.

Research focuses on the histological changes (changes going on in the tissues) metabolic and blood flow changes, neurotransmitter abnormalities and auto immune dysfunctions and are proving to be disappointing. Affected tissues studied appear to be chronically swollen.

It seems the further we look into this mystery illness with the microscope of traditional medicine the further we find ourselves from any resolution. Scientific proof of the disease and proven treatment modalities would be wonderful if they existed; they do not.

If you are diagnosed with FM it is important to work with a physician ñ one that is sensitive to a diagnosis of FM. A physician seasoned in the treatment of FM will have some understanding of the chronic nature of the illness and understand that it is best treated with gentle therapies that will not mask symptoms or cause further problems.

Next week, in part three, I will take look at the most successful natural therapies available. Stay tuned.

Till next time, Rebecca

To find out more about Rebecca Huber and read other articles visit

Part three

In the first two parts of this series, I have discussed the typical scenario of the FM patient and the dilemma doctor and patient both face in trying to diagnose and treat this chronic and disabling disease. This week I'd like to discuss various natural treatment options and one old drug that has proved to be promising to those with FM.

Chronic illnesses, including FM, need gentle sustained therapies that will not cause further damage. This is why Sally, our FM patient discussed in part one, found her medications to be only sometimes helpful -- if at all.

Since most treatment modalities -- traditional or natural -- remain based in theory or anecdotal reports, rather than scientific study, the information presented here will be based on our own experiences treating clients and other sound theory-based information. To best utilize these therapies, learn as much as you can about your disease.

The further away from your health you find yourself, the more gentle and basic you will have to be with yourself. Nothing is more basic to life and good health than proper mineral balance and a digestive system that is strong enough to utilize those minerals. Many patients struggling with FM find a supplement of malic acid and magnesium to be helpful. Magnesium balances calcium, helping to relieve insomnia, muscle aches, balances hormones and helps lift the mood. Malic acid is a substance found in the skin of apples that aids in the digestion of all minerals.

Food sensitivities do put an additional strain on the body and can exacerbate the symptoms of FM. The foods that most often create problems are dairy, wheat, sugar, chocolate, corn, citrus, eggs and highly processed foods. Working with an elimination diet can relieve many of the symptoms and improve energy.

Other important dietary changes would include:

A high quality multi-vitamin

Six to eight glasses of filtered water daily

Increasing intake of raw food, especially raw vegetables

Decreasing meat intake

Adding a digestive enzyme

Useful herbs are astragalus, ginseng, licorice, schizandra, cranberry and Pau D Arco

Massage and bodywork helps relieve muscle aches and tender points. It boosts immunity, helps drain toxins from the lymphatics, increases energy, builds endurance and lifts the spirits.

Water exercise is another important therapy many FM sufferers find beneficial. The patient suffering with FM finds exercise difficult since aerobic exercise or sometimes just simple walking can put enough added stress on the joints to cause an exacerbation of symptoms. Water therapy allows for stretching and exercise vital for recovery without causing further pain.

While writing and researching for this series, a client brought to my attention a book based on the treatment of FM with an old drug called guaifenesin. The book entitled ''What Your Doctor May Not Tell You About Fibromyalgia'', written by R. Paul St. Amand, MD is based in theory. Although my client said she felt her symptoms worsen at first with the use of this medication, she feels her symptoms are now more manageable, stating ''I have days where I just feel normal.'' She also brought to my attention the following web address

I have received more e-mail from this series of articles in the past than any others I have written which speaks for the number of you suffering without help. I could have written another three of four parts to this series and still only given a small window into the disease disorder currently called fibromyalgia. Answers for chronic disease never come easy but there are answers.

A few final words from someone who has suffered a debilitating chronic illness and found her answers: never give up; work with doctors who are sympathetic to your illness and your pain. Try as many natural therapies as you are comfortable using. Don't build your hopes on a string; work with qualified professionals and take your comfort in friends or a support group. Don't ignore your spiritual side and believe that your answers are forthcoming.

Till next time, Rebecca

To find out more about Rebecca Huber and read other articles visit

Uploaded to The Zephyr Online February 5, 2002

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