Fibromyalgia is a condition characterized by diffuse pain in your muscles, ligaments and tendons, as well as fatigue. Multiple tender points or "trigger points" are present throughout the body. These are sensitive areas on your body where slight pressure causes pain to the individual.
Fibromyalgia occurs in approximately 2 percent of the population in the United States. It is more common in women versus men, and the risk of fibromyalgia increases with age. Fibromyalgia symptoms frequently begin after a physical or emotional trauma, but in many cases there is no triggering event.
Patients with fibromyalgia often describe pain as a constant dull ache, typically arising from multiple muscles. To be considered widespread, the pain must occur on both sides of your body and above and below your waist.
Fibromyalgia is characterized by additional pain when firm pressure is applied to specific areas of your body, called tender points or trigger points. The American College of Rheumatology has established two criteria for the diagnosis of fibromyalgia:
1. Widespread pain lasting at least three months
2. At least 11 positive tender points - out of a total possible of 18
Tender point locations include:
Back of the head
Between shoulder blades
Top of shoulders
Front sides of neck
Upper chest
Outer elbows
Upper hips
Sides of hips
Inner knees
People with fibromyalgia are often fatigued, even though they may get enough sleep. Some experts believe that these people rarely reach the deep stages of sleep. Sleep disorders linked to fibromyalgia include restless legs syndrome and sleep apnea.
Some patients with fibromyalgia have other associated conditions such as: chronic fatigue syndrome, depression, headaches, irritable bowel syndrome, lupus, osteoarthritis, post traumatic stress disorder and rheumatoid arthritis.
The diagnosis of fibromyalgia can be difficult to make initially especially in view of the multiple presenting symptoms. See your physician for a complete physical examination, lab work to rule out other disease conditions and imaging studies as your clinical situation dictates. This process is necessary but can be very frustrating for the patient. Rest assured this is a real condition; do not worry about negative test results. If you are not happy with the process it is OK to seek a second opinion, usually with a rheumatologist.
Strategies to manage your fibromyalgia:
1. Reduce stress. Develop a strategy to avoid/limit overexertion and emotional stress. Schedule times to relax each day. That may mean learning how to say "no," Try to maintain a daily active schedule. Try stress management techniques, such as deep-breathing exercises or meditation. Massage therapy may be beneficial.
2. Get enough sleep. Getting sufficient sleep is essential. In addition to allotting enough time for sleep, practice good sleep habits, such as going to bed and getting up at the same time each day.
3. Exercise regularly. At first, exercise may increase your pain, but exercising regularly often decreases symptoms. Appropriate exercises may include walking, swimming, biking and water aerobics. A physical therapist can help you develop a home exercise program. Stretching, good posture and relaxation exercises are helpful.
4. Pace yourself. Maintain a steady pace that allows you to follow a daily routine with the understanding that you will have good and bad days. The right attitude will keep you more on the positive side.
5. Maintain a healthy lifestyle. Eat healthy foods. Limit your caffeine intake. Do something that you find enjoyable and fulfilling every day.
6. Analgesic medications are frequently used in the management of pain with fibromyalgia patients. While this may be necessary at times it is my opinion that more natural treatments may be just as beneficial without the side effects that accompany prescription medications. I am not saying that prescription medications are unnecessary. I do believe however that it is better to use the body's own healing response if possible.
7. Scientific Articles:
a. Sendur and colleagues in the Rheumatology International Journal (2008 Oct 14) showed us that Serum glutathione and catalase levels were significantly lower in fibromyalgia patients than controls. They concluded, "These findings support other studies, we assume that these two antioxidants might have impact on the pathogenesis of fibromyalgia disease.
b. Bagis and colleagues in the Rheumatology International Journal (Volume 25, April, 2005) reported that oxidant/antioxidant balances were changed in fibromyalgia. Increased free radical levels may be responsible for the development of fibromyalgia "These findings may support the hypothesis of fibromyalgia as an oxidative disorder."
c. Parcell in Alternative Medicine Review (2002 Feb;7(1):22-44) discussed the role of sulfur-containing amino acids including cysteine that can help increase the level of glutathione which may be effective in the treatment of fibromyalgia and other disorders.
Recommendation:
Glutathione is an essential antioxidant necessary to fight free radicals. Free radicals may indeed play a role in the pathogenesis of fibromyalgia. Glutathione and catalase levels were significantly lower in fibromyalgia patients. This information has led me to conclude that daily use of Max GXL, a glutathione accelerator and Max N-fuze should be considered in patients with fibromyalgia providing there is no contraindication.
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