The following articles are presented as support for the
possible use of ionic minerals as a dietary supplement and nutritional supplement for
natural therapy. You will find more on fibromyalgia
here. You can also purchase this diet supplement disease treatment package below.
THE TRUTH ABOUT FIBROMYALGIA SYNDROME
This common but misunderstood pain syndrome is yielding to simple treatments
Magazine: Prevention; April 1997
For Peggy (not her real name), a 36-year-old administrator in a
high-pressure job, it all started so simply. Two years ago, she moved a heavy piece of
equipment. Her back began to hurt, but her doctor told her the pain would go away soon.
But it didn't. Instead, it took on a life of its own, throbbing up and down her back. When
medical tests showed nothing, her doctor told her that the pain was probably
stress-related.
The pain intensified and became maddening. The doctor sent her to a
physical therapist. After one session, she felt better. After two, she felt worse.
Next a chiropractor. Then an acupuncturist. Then a massage therapist. And
others. It was always the same story: initial relief followed by more pain in more places.
"After a few months," she recalls, "I could barely move.I was dragging
myself to work. As soon as I got home, all I could do was lie on the floor. I felt like I
was going out of my mind."
Finally she was referred to neurologist Norman Harden, MD, director of the
pain clinic at the Rehabilitation Institute of Chicago. "Even before the physical
exam--after I told him my story--he said it sounded like something called 'fibromyalgia'.
I never heard of the disease."
A lot of other people haven't heard of it either--but they have it. Fibromyalgia
is a musculoskeletal disorder consisting of terrible pain in the muscles and soft tissues
throughout different parts of the body, unrelenting fatigue, anxiety, depression--and a
lack of any obvious causes found in physical examination, blood tests and x-rays. And it's
not rare. The latest studies suggest that it may affect about 2% of the U.S. population.
That means there are 3 to 6 million Americans walking around--or, like Peggy, feeling that
they must lie down--with these awful symptoms.
People with fibromyalgia may feel disabled, no
longer able to hold a full-time job or perform everyday activities. Even hugging can be
painful. Two-thirds are women. Some have seen a dozen or more physicians over the years,
only to be told that their sole problem is hypochondria. But the American College of
Rheumatology, National Institutes of Health (which spent over $2 million dollars on fibromyalgia
research last year), brain researchers and growing numbers of physicians know otherwise.
"Their symptoms are real, with a biological cause," says Cleveland Clinic
rheumatologist William Wilke, MD.
The good news is, simple treatments, including a lot of self-treatments,
can give amazing relief. Sufferers and doctors alike just have to understand what they're
dealing with.
Uncovering the truth
For many people, it's not until they see a rheumatologist that they get a
proper diagnosis. But it's happenstance that rheumatologists end up with the most fibromyalgia
patients. "Fibromyalgia is unrelated to arthritis,"
notes Dr. Wilke. "The only relationship is that patients complain of pain, so they're
sent to us."
It usually doesn't take a rheumatologist long to discover that there's no
inflammatory auto immune disease, like arthritis. Along with physical examination, Dr.
Wilke asks some simple questions. "I ask if they hurt only when they move. Most
inflammatory conditions hurt a lot more when you move, while fibromyalgia
pain continues and may be worse even when you're not moving."
His next questions aren't even about the pain. "Most patients with
fibro-myalgia feel tired, are not sleeping well, and may be anxious and depressed,"
says Dr. Wilke.
Then he asks if they're hurting between the shoulder blades. That's 1 of
18 "tender points" that doctors look for in fibromyalgia.
To meet the American College of Rheumatology criteria for the syndrome, a person must feel
pain in at least 11 of these places when a doctor applies moderate finger pressure. (The
pressure would not bother a healthy person.) Dr. Wilke asks about the area between the
shoulder blades first because, in his experience, it's the most common and painful sore
spot among fibromyalgia patients.
It wasn't until the tender-point examination that Peggy began to believe
the diagnosis. "What really surprised me was when the doctor just touched these
different places--on my neck, on my elbows--where I didn't even know I had a problem. The
pain really shocked me. It was very bizarre, and almost scary. I thought, 'Maybe I really
do have this fibromyalgia.' " Experts agree that it's
important not to get hung up on exact numbers and locations of tender points. "A
better way to think about it is that people with fibromyalgia are
more sensitive all over their bodies," says Dr. Wilke. There's still no single
medical test that can show if a person has fibromyalgia. The
diagnosis is based on careful history, in-cluding a positive re-sponse to the type of
questions Dr. Wilke asks; the tender-point exam; and blood and other medical tests to rule
out serious diseases that can resemble fibromyalgia. Dr. Wilke
notes three diseases physicians can easily confuse with fibromyalgia:
Hypothyroidism A doctor can order a thyroid-stimulating hormone blood test
(TSH) to check for this.
Inflammatory muscle or joint diseases, like arthritis To rule them out,
Dr. Wilke recommends a creatinine kinase (CK) enzyme blood test and a careful physical
exam.
Polymyalgia rheumatica (also called giant cell arteritis) is a rare
autoimmune disease that usually strikes people over 55. Left untreated, it can cause
blindness and stroke. "So particularly for people over 55, a test is a good
idea," says Dr. Wilke.
What's behind the pain
Though there's no diagnostic test available for fibromyalgia,
new research suggests that people with fibromyalgia are
physiologically different. At the University of Alabama, Birmingham, a team of researchers
led by Laurence Bradley, PhD, professor of medicine, division of clinical immunology and
rheumatology, is pioneering this inquiry.
In one study, the team found that the cerebral spinal fluid in those with fibromyalgia
had more substance P, a neuropeptide that carries pain signals. High levels mean that it's
more likely that pain is perceived. In another study, they saw that people with fibromyalgia
had diminished blood flow--meaning less functional activity in two areas of the brainthat
help regulate the amount ofpain signals the brain receives. With this physiology, says Dr.
Bradley, "It's almost like people with fibro-myalgia have a pain filter that's not
working well."
The exact initial trigger for this faulty filter is unknown, but the most
prominent theory is severe stress.
Therapy that works
While there are still many questions about the causes of fibromyalgia,
optimism is the order of the day for those who treat it. So far, there's little scientific
evidence regarding the effectiveness of treatments, but doctors have found remarkably
simple therapies that seem to make people feel better and that make good therapeutic
sense. The best therapy of all, top experts say, seems to be regular, moderate aerobic
exercise.
"It's a simple equation," says Dr. Harden. "The more
exercise they do, the better they can feel." It doesn't matter what kind of aerobic
exercise--swimming, biking, jogging, walking, dancing--as long as they hit their target
heart rate for at least 30 minutes a day. "But it's even better if they do it 30
minutes twice a day," says Dr. Harden. "That's what we recommend for our
patients who are severely affected. And they improve." Why? Maybe because aerobic
exercise beefs up the body's supply of endorphins, a natural pain-dampening,
sleep-deepening substance. Exercise increases levels of serotonin and growth hormone, the
exact pain-reducing, muscle-repair hormone that people with fibromyalgia
may lack. And, Dr. Wilke notes, exercise increases blood flow to the muscles. "We
know that people with fibromyalgia do have slightly less blood
flow to their muscles, which might also contribute to pain. Exercise can reverse
that."
But there's a hitch. Like Peggy, many people with fibromyalgia
simply stop moving because they are in so much pain. Their muscles may have atrophied.
They have to start out very gradually. And even then, some of their fears are borne out;
for the first few weeks, exercise can make fibromyalgia pain
worse. Depending on their tolerance, they may have to cut back somewhat."A lot of my
work involves encouraging people to get over that hump," says Dr. Wilke.
This is the stage when pain-reducing drugs are appropriate. "We
choose from a wide spectrum of analgesic drugs that are safe for short-term use,"
says Dr. Harden. "Aspirin and other nonsteroidal anti-inflammatories (NSAIDS) can be
very effective for some people. What's not appropriate for people with fibromyalgia,"
he says, "is long-term use of dependency-producing painkillers, like the opioids
Percodan and Vicodin."
"At first, it was one step forward and two steps back," Peggy
recalls. "I started my exercise program on a treadmill. But I had to switch to the
water exercise because the pain in my knees was so bad. Eventually, I was able to get back
on a treadmill."
Another therapy that seems to work: antidepressant medications. You'd
almost think that these medications were designed for fibromyalgia.
Scientists believe that the antidepressants may work at the level of the central nervous
system, causing changes in brain chemistry, changes that alter pain perception, deepen
sleep and improve mood.
Experts we talked to say tricyclic antidepressants have the best track
record with fibromyalgia patients so far. "They're non-habit
forming, they're relatively safe and they're particularly good at getting people into
stage 3 and 4 sleep," says Dr. Harden. Unfortunately, the tricyclics do have more
annoying side effects, like dry mouth, than the newer "superselective"
serotonin-enhancing drugs. "There is anecdotal evidence that the newer
antidepressants like Prozac are not as helpful in fibromyalgia,
but that may vary according to the individual," says Dr. Harden.
And he warns that the dependency-producing sleep aids in the
benzodiazapene class are virtually never appropriate for fibromyalgia
patients. "The benzo's are often prescribed for sleep, but they ultimately disrupt
the type of sleep that fibromyalgia patients need most, and they
are addictive," says Dr. Harden.
Even among tricyclics there are differences, so it's important for fibromyalgia
patients to work closely with their doctors over time, to identify the medication and the
dosage that works best for them.
So aerobic exercise and antidepressant medications are the mainstays of
current fibromyalgia treatment. But there are also other self-care
measures that physicians have good reasons to think may help some patients. These range
from massage to stress-reduction techniques and are usually added to exercise and drugs.
(See "Self-Care for Fibromyalgia," on p. 90.)
For Peggy, Dr. Harden's 4-week fibromyalgia
program--in which she started exercising, taking low-dose antidepressants, doing physical
therapy and learning relaxation techniques--let her reclaim her life. "Now, I have
the tools to manage the illness," she reports. "I'm back at work. They didn't
exactly welcome me back--in fact, no one thought I would stick with it. But at my last
review, I got the highest performance rating in the department and a promotion to go with
it."
Self-care for fibromyalgia
Along with aerobic exercise and antidepressant medication, the experts we
talked to mentioned other therapies that seemed to be helpful for their patients. The
reports of their success at this point are preliminary--controlled studies of their
effectiveness are just getting under way now. But these measures are all safe, and there
are good reasons to believe they can help.
Physical therapy People with fibromyalgia may
benefit from several sessions with a physical therapist who is familiar with the syndrome,
says Norman Harden, MD, director of the pain clinic at the Rehabilitation Institute of
Chicago. "They can learn the correct postures for work, sleep or even play, which
makes a big difference in reducing muscle pain." A physician should be able to make a
referral to a physical therapist.
Cognitive therapy "We know that people's thoughts and feelings can
influence the transmission of pain signals through the central nervous system," says
Francis Keefe, PhD, direc-tor of Duke University's Pain Management Program. "By
changing their thinking, feelings and behaviors, people experiencing pain may actually be
able to reduce it." That's why his program teaches cognitive therapy. "It helps
people recognize their overly negative thinking and change it to positive but realistic
thinking."
A physician should be able to refer you to a therapist who can teach you
these techniques.
Stress management In Dr. Keefe's program, relaxation techniques taught to fibromyalgia
patients include meditation, deep breathing, progressive muscle relaxation, guided imagery
and handwarming exercises. Ask your physician for a referral to a psychologist or
stress-reduction program to learn these techniques.
Stretching "When we touch the tender points, people's muscles often
feel ropy and knotted," says Dr. Harden. "Stretching lengthens the muscles and
pulls out some of the ropiness, so it may have a direct pain-reducing benefit." on
the muscles, so it makes sense," says Dr. Harden. If you can't afford a regular
massage, perhaps you can induce your spouse to do the job!
Warm baths and hot tubs "A lot of people tell me that heat
hydrotherapies work," says Dr. Harden.
As with many other diseases, there's a lot of misinformation about
fibromyalgia out there, especially among chat groups on the Internet, our experts say. For
reliable information about fibromyalgia, send a self-addressed stamped business-size
envelope to the National Chronic Fatigue Syndrome and Fibromyalgia Association, P.O. Box
18426, Kansas City, MO 64133. For a free brochure on fibromyalgia from the Arthritis
Foundation, call 1-800-283-7800, or contact your local branch.
PHOTOS (BLACK & WHITE): Woman's back
PHOTO (COLOR): Are you hurting between the shoulder blades? That's 1 of 18
"tender points" that doctors look for in fibromyalgia.
~~~~~~~~
By Cathy Perlmutter with Laura Goldstein
FINDING DR. RIGHT
If you suspect that you or someone you know has fibromyalgia, neurologist
Norman Harden, MD, suggests you start with a family doctor. "Sound them out. Ask them
if they believe fibromyalgia exists, and if they're familiar with the criteria for
diagnosis (like the tender-point exam and a complete history, including questions about
fatigue). If they don't know much about it, they should say, 'I'll go read about it.'
" Handing them this article may be a good starting point.
If the doctor doesn't take the symptoms seriously and you still suspect
fibromyalgia, your best bet is a rheumatologist, a pain clinic, or a physiatrist. There
are even a few neurologists, like Dr. Harden, who have a special interest in fibromyalgia,
but you must ask them directly. SOURCES: Laurence Bradley, PhD, clinical psychologist and
professor of medicine, division of clinical immunology and rheumatology, University of
Alabama at Birmingham; Norman Harden, MD, neurologist and director, Center for Pain
Studies, Rehabilitation Institute of Chicago; Francis Keefe, PhD, director,
pain-management program, Duke University Medical Center; John H. Renner, MD, president,
Consumer Health Research Institute, Kansas City, MO; William Wilke, MD, rheumatologist,
department of rheumatic and immunologic diseases, Cleveland Clinic Foundation.
Mail Order Form Click Here!
View
Shopping Cart / Checkout
