by Dr. Kristen Bovee, Peninsula Naturopathic Clinic and Hydrate IV Wellness Centre –
Fibromyalgia (FM) is not a new syndrome; most people have heard of the condition or know someone who has been diagnosed with the disease. A Scottish physician noted the disease in the 1820’s where patients had muscle and joint stiffness, pain, fatigue and disrupted sleep patterns. Standard tender points were also described. It wasn’t, however, until 1981 that the disease was scientifically confirmed and officially noted as a condition by The American College of Rheumatology in 1990.
Today we still have no official cause of fibromyalgia, but the theory is that the nervous system becomes heightened to pain as a result of injury, infection, or trauma (physical/emotional). Whatever the cause, this disease can be most debilitating as patients look for ways of managing the symptoms. As a naturopathic physician who focuses on seeking the cause of disease, it can be somewhat tricky to decide how to approach patients with fibromyalgia and determine an effective treatment plan.
From what we know about FM there are certain patterns noted:
Muscle and joint pain. Pain sensation involves the nervous system. As a result, it is important to work to calm the nervous system to achieve improvement. Conventional medications commonly prescribed include antidepressants and gabapentin; natural medicines can include magnesium, GABA, and botanical anti-inflammatories such as turmeric.
Inflammation. Infections (viral or other), diet and toxins can all be contributors to inflammation. High sensitivity CRP is a non-specific marker of inflammation that can be done easily through blood work. Certain infections such as Epstein Barr, parvovirus or Lyme infection has been shown to be associated with the disease. Food sensitivities can also be a contributor to low-grade inflammation that makes the joints and muscles more sensitive to pain. These can be tested with simple blood work.
Fatigue is a classic symptom of fibromyalgia. Even though chronic pain can be exhausting, other causes of FM fatigue include poor sleep quality, thyroid deficiency, nutritional deficiencies and chronic immune reactivity due to infection or sensitivity. It is important to test for thyroid imbalances, consider B12 or iron testing and eat a hypoallergenic, alkaline diet to reduce inflammation.
Poor sleep quality. In dealing with FM, pain can be a common disruptor of sleep. Although certain pharmaceuticals can help with sleep, I always recommend doing a trial test with melatonin, magnesium or passionflower to aid and assist with quality sleep. Good sleep hygiene and a mattress that is both soft and supportive seem to help as well.
Brain fog. Most patients with FM suffer with some sort of cognitive impairment, whether that be short-term memory difficulties, slowed thinking or general decline in sharpness and clarity or “brain fog.” Causes include pain overtaking the memory pathways, lack of sleep and the possibility of the brain not receiving adequate oxygen as a result of reduced blood flow from FM. It is important that FM patients exercise gently regularly to improve circulation, have iron and B12 levels checked. Screening for sleep apnea is also a good idea.
Even though the direct cause of fibromyalgia has yet to be discovered, patients can find support for the challenges they face. With individualized health care and proper testing of presenting health issues, FM can be managed so one can function in a more normal, pain-free way.
