Fibromyalgia (FM) is a condition full of mystery, misinformation, misdiagnoses and misguided opinions. For these reasons, it is of interest to me. In this article I aim to review the importance of a proper diagnosis and to outline the elements of an effective, comprehensive treatment plan.
The picture of true FM looks like this:
Extreme fatigue and intolerance to exercise. Generalized pain or tenderness felt throughout the body with sensitivity to touch. Clenching or grinding of teeth during the night, feeling unrefreshed in the morning and having a hard time concentrating during the day. Depressed and/or anxious moods and migraines are common, as are sensitivities to foods leading to symptoms of IBS (gas, bloating, irregular bowel habits).
Although it is not necessary that every one of these symptoms be present for a diagnosis of FM, it is essential that other medical conditions be ruled out before the FM diagnostic label is given. The American College of Rheumatology guidelines require that all lab tests assessing related conditions come back negative before FM is diagnosed.
A full assessment would involve consideration of Rheumatoid arthritis, multiple sclerosis, anemia, hypothyroidism, Lyme disease, cancer and several autoimmune conditions. Physically, it must be determined that the pain isn’t driving solely from muscle sprain, injury or trigger points. As a general rule, when the pain is substantially improved with massage, trigger point therapy, acupuncture/IMS or other physical therapies, it is not FM. True FM patients do not tolerate these treatments well.
The patients I see in my clinic have usually made it to this point: the laundry list of lab tests have all come back normal, the various other treatments they’ve had leave them even more sore than usual. They’re left feeling stuck, misunderstood and demoralized.
Naturopathic investigation takes this process several steps further. Private lab testing allows for the assessment of nutrient deficiencies, mitochondrial energy production, bacterial imbalances within the digestive tract and other metabolic disorders that could be (and often are) major contributors to the symptoms being labeled FM. The goal with these tests is to investigate the cellular biochemistry and to determine where any barriers to optimal cellular function may be found.
After a complete assessment, it is essential to treat the whole person, starting with the fundamentals. Regular adequate sleep cannot be underestimated and supplemental herbs or nutrients may be required to ensure regular rest is achieved. Stress management techniques must be implemented. The diet should be variable and high in nutrient dense whole foods and low in sugar and simple carbohydrates while avoiding all known food allergens, caffeine and processed foods.
A regime of oral supplements and IV therapy must be customized to each individual. The baseline supplements that are safe for all people to start with include magnesium glycinate, B-complex and coenzyme Q10. Special emphasis should be placed on the benefits of intravenous ozone therapy as it has proven to be a highly effective adjunctive treatment.
In summary, fibromyalgia is a multifaceted condition and best results could only be achieved with an individualized, comprehensive plan that corrects the underlying biochemical abnormalities determined through appropriate laboratory testing. The naturopathic/functional medicine model offers hope of significant improvement for the people who suffer from this condition.