This is a chronic debilitating condition which is also called Muscular rheumatism, Fibromyositis or myofascial pain Syndrome. This is a group of nonarticular rheumatic disorders characterised by achy pain, tenderness and stiffness of muscles and also areas of tendon insertions and adjacent soft tissue structures.

Myalgia indicates muscular pain, whilst the term myositis means inflammation of muscular tissue and is an inappropriate term for fibromyalgia when inflammation is not present. For inflammation to be involved there should be heat, redness and swelling and in Fibromyalgia this is rarely the case. However there may be focal points of inflammation known as tender points.

The condition occurs mainly in females and may be induced by intensified physical or mental stress, poor sleep, trauma, exposure to dampness or cold, and occasionally by a systemic, usually rheumatic disorder. It may occasionally occur secondary to a viral or systemic infection.

It is particularly likely to occur in healthy young women who tend to be stressed, tense, depressed and anxious, but also may occur in adolescents (particularly girls) or in older adults often associated with minor changes of vertebral osteoarthritis. Men are more likely to develop a localised Fibromyalgia due to a particular occupational or recreational strain.

People with Fibromyalgia often have a tendency to suffer from Candida albicans (Thrush) and allergies and a flaring up of either of these conditions may leads to the appearance or aggravation of Fibromyalgia. This points to a possible overload on the immune and eliminatory systems and an overwhelming of the bodies defences.

Clinical Symptoms

Gradual onset of stiffness and pain usually begin as a diffuse aching which gradually worsens over weeks and months. The pain can be aggravated by strain and overuse. Tenderness may be present and is usually localised to small tender points "tender points".There may be local tightness and muscle spasm. Sleep is often poor with anxiety, fatigue and irritable bowel symptoms often present.

Prognosis and Treatment - Orthodox

Fibromyalgia may remit spontaneously (in milder cases) with decreased stress, but may become chronic or recur at frequent intervals. Low dose tri-cyclic anti-depressants such as Amitriptyline may be used to promote deeper sleep. It gives a very drugged sleep and the patient usually misses REM sleep patterns and wakes feeling groggy and hung over the next day. Aspirin and non steroidal anti-inflammatories have not been shown to be effective. Hydrocortisone injections may be given to areas of focal tenderness. Appropriate exercise, application of heat ,gentle massage and a low dose tricyclic anti-depressant seems to be the treatment of choice.

Holistic treatment.

Anyone who has had any dealings with fibromyalgia patients would agree that REST is paramount to the successful treatment. Beyond that diet, massage, herbal remedies, relaxation and visualisation techniques can all be usefully employed. Detoxification, tissue cleansing and allergy management are vital.

Diet.

Very many patients with Fibromyalgia suffer from an accumulation of toxins, especially acid wastes which tend to aggravate muscle inflammations and spasms, ultimately leading to arthritic changes in the joints. Initially a cleansing and detoxification programme will ease the load on the immune system and liver and remove acid wastes. A short fast should be undertaken the best method being a mono-food fast on white/green grapes or vegetable juice (carrot, beetroot, celery and parsley). This should be followed for as long as can be tolerated from 3 days up to a week. Most patients find 3 days difficult. However you may be surprised at what you can achieve.

The main toxins that accumulate in your body are acidic and nitrogen containing urea, uric acid,pyrimidines and purines. The acids and nitrogens are formed from the digestion of animal proteins, (all meats, seafood’s and dairy products). Certain proteins are worse than others, pork is worse than chicken, milk and cheese are worse than yoghurt and butter. Other acid forming foods are wheat,( especially refined flour products), sugar, tea, coffee, alcohol, vinegar (except apple cyder vinegar), pickles, processed and tinned foods, tomatoes, rhubarb, gooseberries, red and black currants, cooked spinach, margarine, all processed foods, eggs, chocolate, cod liver oil and peanuts.

A maintenence diet, should therefore avoid all the above foods and concentrate on fresh fruits and vegetables with limited amounts of cereal/grains, occasional fish and chicken and no processed or artificial foods at all.

The Following Foods are recommended:

Almonds, Artichoke, Barley, Black figs, Celery, Cherries, garlic, Goats milk, kale, Lettuce, Limes, Olive Oil, Onions, Pineapple, and Watercress.

The following Juices are also recommended:

Black Cherry, celery and Parsley, celery and Apple, Cucumber, Endive, Black Fig and Goats Milk.

Supplements:

Vitamin E.

This vitamin has anti-inflammatory action due to its effect on prostaglandin and leukotrine formation and it acts synergistically with other anti-oxidants as a free radical fighter. It inhibits the enzymatic breakdown of cartilage and stimulates cartilage synthesis. It should be taken in the form of d-alpha-tocopherol at a dose of 400iu./day.

Vitamin C.

As an essential nutrient for tissue repair, any deficiency of Vitamin C will lead to poor healing. In combination with Vitamin E, this vitamin will enhance the stability of the sulfated prteoglycons that make up cartilage and strengthen the tissue. It should be taken to bowel tolerance.

Eiosapentaenoic acid. (EPA)

Supplementing the diet with fish oils that provide EPA enhances the formation of anti-inflammatory leukotrines. Clinical trials have shown that 1.8gms per day was an effective dose.

Selenium.

This is a powerful radical scavenger and anti-oxidant that appears to work synergistically with Vitamin E. It also inhibits the formulation of the inflammatory leukotrines. Serum levels of selenium may be low in people with fibromyalgia and this suggests it is a useful supplement at 200mcg./day

Zinc.

This is another anti-oxidant that may be low in people with fibromyalgia. It is also essential for tissue repair. A supplement of 15 - 30mg./day may be helpful.

Manganese.

This is often low in people with musculo-skeletal disease. Supplementing with Manganese at a dose of 15mg./day minimises free radical damage.

Green Foods (Chorella, spirulina, wheat grass etc.,

These are rich in natural vitamins and minerals and also provide a high level of chlorophyll. They tend to support detoxification of the cells and improve oxygenation of the tissues which leads to improved energy levels.

Lifestyle.

It is most important to exercise regularly. Warm up should always proceed more vigorous exercise. Swimming, yoga , tai chi and walking may be more appropriate to start with whilst energy levels are low. Rest and relaxation is very important. Even if sleep is poor the patient should be encouraged to lie down and rest at various intervals throughout the day. Meditation and visualisation could be introduced if acceptable. When at rest the parasympathetic nervous system is predominant and the sympathetic nervous system less active. It is during parasympathetic dominance that most tissue healing , recuperation and repair occur, hence we must make time to relax in order to heal.

Massage therapy can be very helpful. Getting a member of the family or a friend involved is often the best course of action, then the patient can have therapy on a regular basis and results can be amazing. Massage particularly on the tender points can work well if very uncomfortable. No pain No gain!!!.

Hot applications, (heating pads, hot water bottles etc.) are soothing for the pain and stiffness. Hot mineral baths can also be appropriate. See Leaflet on Epsom Salt Baths.

Essential oils in baths can also be very relaxing. See Essential Oil leaflet.

There are many herbal preparations that can be used to reduce muscle ache and stiffness, improve circulation etc. there are many combinations that can alleviate the many symptoms of this distressing condition. I like to treat the individual for this condition, please contact me and I will make up a specific formulation to suit you.

You can send to the Fibromyalgia Association for a Free Information Pack. Send an A5 Envelope stamped with a 35p stamp to :

FMA UK

PO Box 206

STOURBRIDGE

WEST MIDLANDS

DY9 8YL.