What is Fibromyalgia?
Fibromyalgia effects about 4 million people including 2% of the adult population according to the CDC. There is no “root cause” to this condition as of yet but many integrative and functional doctors dig in a little deeper than conventional doctors by checking additional labs to rule out autoimmune conditions, chronic infections, metabolic imbalances, nutritional deficiency, food intolerances/allergies, chemical toxicities, and GI problems that could be contributing to some of the symptoms. Fibromyalgia tends to affects women 20 more than men and is seen in women ages 20-50. (3) It is seen in families so there is believed to be a genetic and or environmental link(4).
What are the symptoms?
Symptoms of fibromyalgia can be confused with chronic fatigue syndrome and hypothyroidism and is usually a clinical diagnosis of exclusion after ruling out other conditions. Symptoms include fatigue, chronic aches and pain, anxiety, depression, insomnia, brain fog, headaches, as well as weight gain.
What are the signs?
The physical exam for fibromyalgia diagnosis is important. Physicians usually have to make sure the patients have pain both above and below the waist for at least 3months and have 11 tender points along 9 paired sites of the body. Fibromyalgia can be seen with other conditions including PMS, restless leg syndrome, TMJ, amongst others.
How is it treated?
Pharmacologic treatments include antidepressants, anti-anxiety medication, sleep aids, pain medication, muscle relaxers as well as anticonvulsants.
Maintaining a healthy weight through an anti-inflammatory diet and encouraging patients to maintain an active lifestyle is key by incorporating strength training and cardiovascular exercise. This can be a catch 22 because patients often feel bad and don’t have the energy to even get out of bed. Aerobic exercise is best (5-6)
What Integrative therapies work?
Other treatments that work for patients include acupuncture, chiropractic care, yoga, tai chi, massage therapy, tender point injections as well as behavioral medication treatments like therapy, and mindfulness mediation,
Studies are now showing that CBD oil can be used to treat fibromyalgia and chronic pain which is a new and exciting time for these patients. There is a low side effect profile and patients have been tolerating it well by inhaling it, rubbing it on their skin or putting drops in their foods. CBD oil has numerous anti-inflammatory effects which make patients tolerate it well (1). Also prescribing low dose naltrexone (LDN) has been promising for patients as well (2).
3. Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995;38:19–28.
4. Neumann L, Buskila D. Epidemiology of fibromyalgia. Curr Pain Headache Rep. 2003;7:362–8.
5. Gowans SE, deHueck A, Voss S, Silaj A, Abbey SE, Reynolds WJ. Effect of a randomized, controlled trial of exercise on mood and physical function in individuals with fibromyalgia. Arthritis Rheum. 2001;45:519–29.
6. Busch A, Schachter CL, Peloso PM, Bombardier C. Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev. 2002;(3):CD003786