Fibromyalgia (Holistic)

Fibromyalgia is a complex syndrome with no known cause or cure. Its predominant symptom is pain in the fibrous tissues, muscles, tendons, and ligaments, although other symptoms may be experienced.

Research has demonstrated that the axis connecting the three glands primarily responsible for the stress response (hypothalamus, pituitary, adrenals) may be dysfunctional in people with fibromyalgia.¹ Inflammation of the involved structures is generally absent in fibromyalgia.

Of the estimated three to six million people² affected by this disorder in the United States, the vast majority are women between 25 and 45 years of age.

Trigger-point pain at characteristic locations is the defining symptom of fibromyalgia. The most commonly affected locations are on the occiput (nape of the neck), the neck itself, shoulders, trunk, low back, and thighs. Other symptoms may also be experienced, including fatigue, chest pain, low-grade fever, swollen lymph nodes, insomnia, frequent abdominal pain, irritable bowel syndrome, and depression.³

Low-intensity exercise may improve fibromyalgia symptoms. People with fibromyalgia who exercise regularly have been reported to suffer less severe symptoms than those who remain sedentary.^{4, 5, 6} In a controlled trial, a program consisting of two 25-minute exercise classes plus two educational sessions per week for six weeks resulted in immediate and sustained improvement in walking distance, fatigue, and well-being in a group of people with fibromyalgia;⁷ however, no reductions in pain, anxiety, or depression were seen. In a more recent controlled trial, a 35-minute exercise program in a warm pool once a week for six months, coupled with counseling sessions, led to improvements in hand-grip strength and endurance, as well as to reductions in pain, distress, depression, and anxiety.⁸ The results of this trial, and other similar trials, suggest that underwater exercise training, in combination with a counseling intervention, should be considered by people with fibromyalgia.

Stress is believed by some researchers to be capable of aggravating fibromyalgia symptoms. Stress-reduction techniques, such as meditation, have proven helpful in preliminary research.⁹

Acupuncture may be useful for short-term relief of fibromyalgia symptoms. In one preliminary trial, acupuncture produced a significant decrease in pain and point tenderness along with related biochemical changes measured in the fibromyalgia patients’ blood.¹⁰ Another uncontrolled trial used electroacupuncture (acupuncture with electrical stimulation) treatment in people with fibromyalgia who were unresponsive to conventional medical therapies. After an average of seven treatments per person, 46% claimed that electroacupuncture provided the best relief of symptoms when compared to all other therapies, and 64% reported using less medication for pain relief than prior to electroacupuncture.¹¹ A double-blind trial compared fake acupuncture to electroacupuncture and reported significant differences in improvement in five of eight outcome measurements among people with fibromyalgia.¹² Short-term pain reduction in people with fibromyalgia has been reported in other studies, some of which were at least partially controlled; however, long-term benefits have never been investigated in a controlled clinical trial.¹³ Long-term controlled trials are necessary to conclusively determine whether acupuncture is a useful treatment for fibromyalgia.

Joint manipulation, chiropractic, and related treatments may be helpful for relieving some of the symptoms of fibromyalgia. A preliminary study¹⁴ found that almost half of people with fibromyalgia who received chiropractic care had “moderate to good” improvement. A small preliminary trial¹⁵ evaluated the effect of four weeks of chiropractic treatment (three to five times per week) consisting of soft tissue massage, stretching, spinal manipulation, and general advice and information. Treatment resulted in a significant decrease in pain and an increase in range of neck movement, but there was no improvement in tender points or in ability to function in daily life. Another preliminary trial¹⁶ evaluated a longer treatment period (30 sessions) consisting of spinal manipulation and deep pressure massage to tender points in the muscles. More benefit was reported by this study, as 60% of the patients experienced significant pain reduction, reduced sensed of fatigue, and improved sleep. These benefits persisted one month after the treatment was completed. People who did not feel better after 15 treatments were not likely to benefit from this type of treatment. No controlled research has evaluated manipulation therapies for fibromyalgia.