Fibromyalgia
Denver Fibromyalgia Care
At Avicenna Acupuncture Clinic, Igor Zielinski L.Ac has specialized in the treatment of fibromyalgia. Traditional Chinese Medicine (TCM) is excellent for decreasing the pain associated with fibromyalgia. Coexisting conditions like insomnia, depression, or irritable bowel syndrome can be reduced significantly, if not eliminated.
Specialized in the Treatment of Fibromyalgia
In my practice, I have found TCM to be very effective in treating fibromyalgia with its coexisting symptoms. I have found that a holistic approach is the most effective. This approach includes acupuncture, nutritional counseling, herbal medicine, and physical exercises.
My extensive western medical knowledge as an MD helps analyze lab results and find and eliminate potential sources of infection or inflammation. On our clinic’s website and blog, I will continue to present new and old research data, news, and “outside-the-box” ideas concerning the treatment of fibromyalgia.
On a personal note: Unfortunately, patients with fibromyalgia are often misunderstood. I have heard many patients complain about being labeled as “crazy” (yes, I am serious) and/or as a hypochondriac by their physicians, friends, and family. The phrase they often hear is: “It’s all in your head.” It must be incredibly frustrating to listen to this when you hurt all over and are asking for help. I encourage my patients to bring their loved ones for their initial consultation to discuss possible misconceptions about fibromyalgia.
Definition of Fibromyalgia
Fibromyalgia is a disorder characterized by chronic, widespread pain. Chronic means that symptoms last more than three months. Widespread means that pain appears in all four quadrants – upper and lower, left and right. Diagnosis is established by confirming the presence of 11 or more tender points and by ruling out other conditions that may present similarly. There is no blood test that confirms fibromyalgia.
Diagnosis of Fibromyalgia
“Bene diagnoscitur, bene curatur” – Good diagnosis – good treatment
This Latin proverb is still relevant today. Without a good diagnosis, there is no good treatment. This is precisely the dilemma with fibromyalgia.
There is no diagnostic test yet that positively confirms a fibromyalgia diagnosis, and the symptoms are often diffuse. Many disorders present with very similar symptoms as fibromyalgia, e.g. chronic fatigue syndrome, chronic infections (Hepatitis B or C, Lyme disease, EBV), SLE, rheumatoid arthritis (RA) to name just a few. Those other disorders need to be ruled out BEFORE a fibromyalgia diagnosis can be made affirmatively. Patients with fibromyalgia are diagnosed by a process of elimination.
Fibromyalgia most often affects young or middle-aged females. Widespread pain is the main symptom. It might be accompanied by fatigue, insomnia, depression, anxiety, cognitive difficulties (known as fibromyalgia fog). All those symptoms significantly impair the patient’s daily life.
Etiology (Cause/Origin) of Fibromyalgia
Unfortunately unknown. So far, there are hypotheses only. Researchers discovered links between the levels of certain neurotransmitters and symptoms of fibromyalgia. Neurotransmitters are chemicals that transfer signals between cells.
Substance P
One type of neurotransmitter is called Substance P. One of its functions is to transmit pain sensation to the brain. Studies show that patients with fibromyalgia have elevated levels of Substance P in the spinal fluid, serum, and soft tissue.
Serotonin
Serotonin (5-hydroxytryptamine) transfers messages between different areas of the brain. Serotonin regulates the mood, sleep, appetite, memory, and libido. Serotonin levels are lower in patients with fibromyalgia.
HPA Axis
The “hypothalamus-pituitary-adrenal axis” is part of our hormone system in which researchers noticed abnormalities in fibromyalgia patients. It regulates our physical response to stress as well as sleep and mood.
Growth Hormone
Researchers found that about one-third of fibromyalgia patients also have low levels of growth hormone. That would be another hormone system involved in the pathogenesis of fibromyalgia.
All the above findings have been connected to patients that have fibromyalgia. Unfortunately, it is unclear if the changes in neurotransmitters and hormones are the causes of the outbreak of fibromyalgia OR if they are part of the development of the disease (it’s something of a chicken and the egg debate).
Western Medicine’s Approach to Fibromyalgia Treatment
Pharmacological treatment goals are to address pain, muscle tension, insomnia, depression, and anxiety. Some of the available drugs can perform two or more functions. Many medications have multiple severe side effects. All western medicine available for the treatment of fibromyalgia solely decreases symptoms. They have no curative effect.
On our website, we do not provide detailed information about western medical treatments for fibromyalgia. The list below is intended only to educate you in all treatment forms available. Discuss questions or information about any prescription medication should with your prescribing physician, including the termination of medications.
Muscle Relaxants
Flexeril (Cyclobenzaprine)
Mirapex
Mirapex is used for Parkinson’s disease. According to research it helps with fibromyalgia pain. It is also effective for restless leg syndrome, which often accompanies fibromyalgia.
The physician should not treat the disease but the patient who is suffering from it.
– Maimonides
Alternative Treatments for Fibromyalgia
Acupuncture
There is an increasing amount of research showing the effectiveness of acupuncture in treating fibromyalgia pain a well as the associated symptoms. We have found that patients report multiple benefits from this course of treatment.
Massage
Specialized massage can serve as a wonderful therapeutic intervention to relax and nourish the muscles. It is non-invasive, and most people enjoy it. Unfortunately, some patients cannot tolerate ANY pressure, especially over the trigger points.
Herbs
We use Chinese herbs at Avicenna Acupuncture. We have our own herb pharmacy with more than 150 individual herbs. Since fibromyalgia has a multitude of clinical presentations, we mix several single herbs to make a specific formula for you.
Dietary Supplements
A few supplements are recommended specifically for fibromyalgia. Always consult a healthcare professional before you start taking supplements. Some might interact with medications you are already on, and some might produce different side effects. The following list is not complete and the effectiveness of these remedies varies:
– Carnitine
– CoQ10
– Magnesium
– D-Ribose
– Vitamin B12
– DHEA
– Vitamin D
– 5 HT
– Omega 3
– Rhodiola
– Saint John’s Wort
– Sam-e
– GABA
Lifestyle – Diet – Exercise
Last but definitely not least, I consider changes in lifestyle more critical than taking medications or herbs or applying other treatment methods. In the long run, without improving lifestyle pain gets worse and other treatments often become less and less effective.
Fibromyalgia and Chinese Medicine
Traditional Chinese Medicine is a holistic system of diagnosing, treating and preventing diseases. Fibromyalgia is a textbook example of proving the effectiveness of Chinese Medicine and its ability to treat chronic diseases. According to Chinese Medicine fibromyalgia is a complex syndrome. That means it consists of a combination of several different syndromes which depend on their etiology (origin) and symptoms.
Dampness
Dampness in the body creates stagnation – imagine the resistance when walking through water. In Chinese Medicine theory stagnation or blockage of the smooth flow of energy and blood causes pain.
Heat
Heat symptoms include – insomnia, irritability, palpitation and anxiety. These aggravations are very common in fibromyalgia patients. The described processes of creating damp and subsequently creating heat will use up precious resources – energy and nutrients. Over time the body gets weaker and less energized. Even activities of daily living can become a huge burden. Lack of energy directly impacts the immune system making the body more prone to infections.
This vicious cycle, once in place, is difficult to brake.
– Unknown
Fibromyalgia Treatment at Avicenna
In Traditional Chinese Medicine, treatment of Fibromyalgia consists of diet, acupuncture, herbs and supplements, as well as physical activity. After a diagnosis has been established, we create an individualized treatment plan, which includes all afore mentioned modalities. Patient commitment and compliance in the established treatment plan is crucial for positive results.
Diet
Without a healthy diet, there is no way to treat fibromyalgia successfully. The general rule is to drastically limit simple carbohydrates. At Avicenna Acupuncture Clinic we provide specific dietary recommendations to each patient. Sometimes we recommend a “cleanse” that will help to detoxify the body and regulate the digestive tract. It is like resetting the digestive system to a new pace. This will clear up many of the digestive issues.
Acupuncture
Acupuncture has an analgesic (pain reducing) effect, which is caused by the endorphin release. It increases the blood flow to sore muscles. It balances the neurotransmitters in the brain and therefore reduces feelings of depression, anxiety, fatigue and brain fog. It is common that after an acupuncture treatment patients have more energy and better focus. Acupuncture regulates the digestive tract. This is a very important function, because it not only helps with the symptoms but also improves absorption of nutrients and supplements. This in consequence will increase your immune system.
Herbs and Supplements
There is a vast amount of beneficial supplements. Generally the supplements will help your body to establish a healthy digestive tract and immune system. Since we treat every patient individually it is impossible to write a generic list of recommended supplements. What works for your neighbor or friends, might not work for you. You can find information and updates on the supplement page.
Fibromyalgia and Physical Activity
Physical activity – This is the best, cheapest, easiest, most effective and my favorite treatment method. I didn’t use the word “Exercise” on purpose. It is not about training, it is about physical activity. Make a list of things you enjoy. Any kind of recreational activity counts. The keywords here are FUN and ACTIVE. For some people being active means running a marathon, for others walking or biking around the block. Fibromyalgia patients have difficulty being active. Sometimes getting out of bed is a huge effort. When you hurt all over you don’t want to do anything. Do it anyway; start small and build up from there. DILIGENCE is another keyword. Be active every day, no matter what.
As a Chinese Medicine practitioner, I cannot miss this opportunity to introduce “Tai Chi”. This exercise system originated in China and has been practiced for centuries. Tai Chi consists of a sequence of simple movements that are easy and not strenuous. It balances and strengthens the body, helps with pain, elevates your mood and energy level. Tai Chi can be practiced in a group or individually. Another great activity is Yoga. It can be a little more demanding and finding a good teacher is crucial.