“Many people do not realize the toll stress can have on their lives. Caring for mind and body leads to a healthier, happier and more productive life.” Cynthia Wainscott

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January 13, 2017

Fibromyalgia – Causes – Symptoms – Treatment

Young woman cryingCauses of Fibromyalgia (FM)

For many years there has been a controversy surrounding the causes of FM, namely whether it is a medical or psychological problem.  Today we know that FM is due to changes in the brain and spinal column and we know that it affects body & mind. What is still not clear is what causes these symptoms.  However, from clinical interviews of patients we know that the following conditions be causative in FM :

  • Trauma and injury contribute significantly to FM
  • Prolonged stress (home life, work, or other life changing events)
  • Prolonged low-grade depression

We also know that

  • 5 million Americans suffer from FM
  • The vast majority of FM sufferers are women – 7x greater than men
  • Women with FM often suffer from additional ailments such as
    • Chronic fatigue, endometriosis, TMJ, IBS, lupus and others
    • FM does not respond to anti-inflammatory or opioid drugs – drugs that are designed to address physical pain
    • All FM symptoms get worse with stress

Symptoms of FM

Diagnostically, there is not one test that can determine a diagnosis of FM and the diagnosis needs to be established through thorough clinical interviews, and at times a functional MRI can assist in ruling out other disorders.

Fibromyalgia not in your Head – it’s in the Brain

The main symptom of MF is widespread body pain. The pain is experienced as aching, exhausting, nagging and hurting.  There is great sensitivity to pain and any pressure stimulation.  There may be numbness, tingling & headaches. There is much fatigue, sleep disturbance, sensitivity to sensory stimuli, and mental health symptoms like anxiety and depression.

What makes FM symptoms worse

We know that many forms of stress increase symptoms, and frequently push symptom intensity to intolerable and disabling limits.  The following percentages were derived by polling patients as to the types of stress that aggravates their symptoms:

Type of Stressor Percentage of people who said that this stressor aggravates their symptoms
Emotional Stress

83%

Weather Changes

  80 %

Sleep problems

       79 %_

Strenuous Activity

    70%  __

Mental Stress

68% ____

Worrying

60% ______

Car travel

57%________

Family Conflicts

52%____________

Physical Injuries

50%_____________

Physical Inactivity

50%_____________

Infections

43%____________________

Allergies

37%_________________________

Low to mod. Physical activity

36%__________________________

Lack of emotional support

36%__________________________

Time zone changes

34% __________________________

Airplane travel

34% __________________________

Perfectionism

32% ___________________________

 

What we can see from this patient data is, that many daily stressors significantly impact symptom expression of FM and significantly determine quality of life.

What does Help and is the Best Treatment

Currently FM is being largely treated by the medical community in rheumatology and neurology departments.  Medical treatments may include Lyrica, Cymbalto, Savella or a combination of serotonin and norepinephrine medications.  Naltrexone, an opiate antagonist has shown some promise in small studies; it seems to boost immune function at a low dosage but it’s role in FM, to date, is not well understood.  Naltrexone, at this time, is not approved by the FDA for the treatment of FM.

Holistic treatments, including naturopathic medicine, yoga therapy, mindfulness based psychotherapy and CES alpha-stim all have shown to improve the symptoms of FM and help sufferers from the disorder gain control over their illness.

Holistic treatments that increase the relaxation response have the greatest efficacy in the treatment of FM.  Profound relaxation, that we can experience in yoga and massage therapy, CES alpha stim and mindfulness therapies, all decrease hyperarousal of sympathetic nerve pathways, the pathways that are engaged in the stress response.  Here are some interesting research highlights*

CES Alpha Stim: of 505 patients 138 patients improved between 50-100% (patient survey AJ of Pain Management, 11 (2):62-66, 2001

 

  • Massage: 75 % of FM sufferers utilize massage therapy to help them reduce pain, anxiety, depression, stiffness & fatigue, and to improve quality of life, sleep, and overall health status.
  • Yoga Therapy: Small studies and personal reports show significant improvement in the overall health status of yoga therapy participants and in symptoms of stiffness, anxiety, and depression. Significant improvements were also seen in the reported number of days “felt good” and number of days “missed work” because of fibromyalgia.
  • Mindfulness: Mindfulness based stress reduction significantly reduced perceived stress, sleep disturbance, and symptom severity, with gains maintained at follow-up as reported by the NIH in a small study.
  • Trauma Therapy: Many patients suffering from FM have an extensive trauma history.  Helping our patients move psychologically and somatically through their trauma makes a huge difference in their ability to modulate and reduce their pain experience.

 

*often the sample size is small, since complementary and alternative programs frequently do not have the financial means to conduct larger scale studies.

Putting It All Together

Health Psychology Sacramento offers intensive outpatient programs for patients who suffer from Fibromyalgia.  The programs are non-drug based and offer individualized holistic treatments.  Each person works with a personal treatment team that guides treatment efforts to normalize an overactive stress and pain response.  The focus of treatment is:

  • To reduce pain and rebuild a positive relationship to body
  • To understand trauma triggers
  • To create a self-care practice to nourish mind and body
  • To nourish the body with a wholesome diet
  • To address associated mental health symptoms of anxiety and depression
  • To connect to an inner place of calm and strength
  • To rebuild relationships
  • To engage in the community

We achieve this by introducing an approach to mindfulness that no longer sees the body as the enemy but supports and increases parasympathetic brain function, the part of our nervous system responsible for healing.  All interventions are geared toward balancing body & mind.

If you are interested in our program and wish to discuss how you or your loved one can improve and heal, call our director, Dr. Ursula Stehle at 916.962.0222, ext. 1#.

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