Fibromyalgia

[Guest guest]

http://www.consciouschoice.com/features/fibromyalgia.html

Fibromyalgia

by Edelberg, M.D.

Conscious Choice, February 1999

A Background

You had to have been at Northwestern University's Thorne Hall that chilly

March day to realize the extent of the fibromyalgia epidemic, now estimated

at upward of 10 million, with probably millions more undiagnosed, mostly

women. Here in the crowded auditorium, hundreds arrived from throughout the

Midwest for an all-day symposium, trying to learn why they felt so

physically and emotionally drained, day after day. Some reported decades

without a pain-free day and wondered why the medical profession had failed.

All wanted to know what help was available and what they could do for

themselves.

It helps to get the term right. The word, " fibromyalgia " is about as precise

as " headache. " From the Greek, it simply means, " pain in the fibrous tissues

of the muscles, " describing a symptom rather than a disease. Once a doctor

suspects you've got it, the diagnosis can be confirmed in less than two

minutes by applying pressure to the so-called " tender points " and eliciting

pain. No blood tests; no x-rays; no biopsies.

However, let me describe fibromyalgia in the words of the patients

themselves: " I awaken in the morning exhausted, like I haven't slept. My

body aches until I can get into a hot shower and then limber up. I feel old

and wonder: what will the next forty years be like? " Here's a milder case:

" I've always carried my stress in my neck and upper back but now the pain

seems to be spreading. I'm at the chiropractor's office every week but the

adjustment only lasts 2 or 3 days. "

Sometimes the diagnosis is badly missed: " They said I had a bulging disc in

my neck and convinced me that an operation would help. Eight weeks after

surgery, I realized nothing had changed at all. " And all too often, the

patient is dismissed as neurotic: " I knew he was tired of me in his office

every week when he said I was depressed and referred me to a psychiatrist

who gave me some Prozac samples. "

Beyond the total body muscle pain and the fatigue are the secondary

symptoms. These are so numerous that as a doctor, I sometimes wonder how

these women survive. Here's just a sampling of what regularly accompanies

fibromyalgic pain: interrupted and unrefreshing sleep; brain fog

( " fibro-fog " ) with reduced short term memory and poor concentration; chronic

sinusitis and frequent colds; irritable bowel symptoms, like constipation

and diarrhea; severe PMS; inability to stand for a long time without feeling

faint; under-active thyroid symptoms (cold intolerance, cold extremities,

weight gain); thirst; absence of libido; recurrent vaginal yeast infections;

and, not surprising given this list, depression.

However, it's equally important to state what fibromyalgia is not: It is not

an autoimmune disease (there are no blood tests 'positive' for anything

specific. In fact, if there are 'positive' tests, fibromyalgia is

eliminated); it is definitely not depression or a mental illness (and you

should walk out immediately from any doctor who tells you it is); it does

not lead to anything serious, deforming or life threatening; it is not the

so-called " chronic fatigue syndrome " which strikes men and women in equal

numbers, although CFS has many fibromyalgia features.

Most important, although classified as a 'chronic' illness, it can be so

completely treated that I'd almost be tempted to use the word " cured. " The

only problem with stating " cure " is that if the same circumstances that

brought the disease in the first place manage to return -- resetting the

stage, so to speak -- then symptoms begin reappearing. If, however, someone

with fibromyalgia learns from the experience, deals with whatever set the

stage, and makes appropriate life changes, the condition can disappear.

Forever. But more on life issues later.

Symptoms as Messages

When annoying, persistent, or especially uncomfortable sensations persist in

the body, we call these sensations " symptoms. " Sneezing is a symptom but may

not mean a disease. Most symptoms, in fact, do not mean " disease, " and do go

away by themselves. Even longstanding symptoms are frequently just messages

that your body would like you to heed. Painful knee when you jog? Stop

running for a while. Get a headache at four o'clock every day? Regard the

headache as a message, and think about changing your lunch. If you change

your habit and the headache vanishes, you've learned something and found a

way to improve your health.

Now let's apply some of this " body message " stuff to fibromyalgia. That the

condition afflicts mostly females begs us to hunt for some meaning. There's

a message here...and it's really no surprise. After years of listening to

life stories from patients of both sexes, I am thoroughly convinced that

women go through life both experiencing and then internalizing more

day-to-day stress than any male could ever imagine. Any historically

oriented feminist will tell you the situation: by being compelled to share

the planet with creatures whose testosterone hard wires aggressiveness, and

by being deprived of sufficient muscle mass to defend themselves, women,

from the moment they are born, struggle, endure, and too often must submit

to a hostile, polluted, threatening world they might never ever have created

had they been in charge.

So here is a sweeping generalization about fibromyalgia: virtually every

single case I've encountered in my practice has emerged when the background

" white noise " of chronic stress either becomes intolerable or is escalated

by new events in a person's life. And, to take this one step further,

fibromyalgia is not so much a disease with a definable villain (like a

virus, or an immune problem) but rather a physical reaction to stress that

spins out of control. Fibromyalgia is a system breakdown, sort of like what

would happen to your car engine if you floored the accelerator with the

transmission in neutral. Stressed men tend to get heart attacks and ulcers,

or languish in depression. Stressed women might be vulnerable to

fibromyalgia.

The Body Reacts to Industrial Strength Stress

First, let's talk about muscle pain. Here's a piece of troubling data: a

study from England showed that about 15 percent of women with fibromyalgia

came from abusive homes. Imagine yourself in this painful scene: you're a

child with an alcoholic, violent, and unpredictable father who is arriving

home from the pub. You're seven years old and one of the household gods is

angry. You just might get hurt. You brace yourself for the worst. Stop now

and picture what " brace yourself " means: body into a protective position,

muscles taut, head down, shoulders forward, back rigid to ward off real (or

imagined) blows. Whether or not you actually get hit, you assume this basic

instinctive posture. Protective posture is present in children of both

sexes, but some of us carry it into adult life. ( " I carry all my stress in

my neck " ). We instinctively tighten our necks and upper backs when

attempting to protect ourselves from stressors, physical and emotional,

perhaps warding off the blows from life itself. Eventually, something

changes in the muscles themselves: locked in a position to protect the body,

key points, the " tender points " are palpable areas that really hurt when

touched. The chronic stress and the chronically " locked " position have

somehow changed the muscles.

But although the neck and back are fibromyalgia's most painful points,

sufferers report discomfort throughout the body, as if all the muscles were

in spasm. In fact, they are. Intense muscle contractions are one of the

" correct " responses to a sudden unexpected stress, through a complicated but

involuntary pathway involving both the nervous and endocrine systems. An

example: you're walking down the street and suddenly confronted by a mugger.

There's an immediate involuntary transmission of information through your

nervous system ( " DANGER! " ), relayed from your brain, down through your

pituitary (or 'master') gland, to release adrenaline and cortisol from your

adrenal glands. These tighten your muscles in preparation for fighting or

running away. Your adrenals: two bean sized glands atop the kidneys, which

release a variety of hormones during any stress. However, we only need these

hormones for special occasions, as we're not constantly getting mugged. Or

are we?

Remember, stress -- real unadulterated stress -- may well be the unwanted

traveling companion for many of us, especially women. Going through a day

expecting to be physically or emotionally attacked, or simply trying to

survive in a world where there's no sense of control, one's adrenal gland

switch stays " on. " What follows are just about every one of the accompanying

symptoms of fibromyalgia.

Here's a list of what chronic and inappropriate cortisol and adrenaline

secretion can cause: adrenal exhaustion (fatigue, a weakened immune system,

low blood pressure); brain fog (excessive cortisol is toxic to brain cells);

weakened thyroid (fatigue, cold intolerance, weight gain despite calorie

restriction); " fear " responses (cold hands and feet, palpitations, chronic

anxiety, tightness in the throat, insomnia, irritable bowel syndrome). In

turn, the weakened immune system predisposes to recurrent colds, vaginal

yeast infections, sinusitis, and intestinal parasites. In other words, all

the symptoms of fibromyalgia

This can go on for years. In my practice, an older woman told me her family

doctor had diagnosed " rheumatism " when she was 25 years old and every single

day for the ensuing four decades she experienced muscle pain and tiredness.

She had no real memory of being " pain-free. "

Again, I can only repeat...virtually every case of fibromyalgia I've seen

begins with a series of heightened stress " events, " usually uncontrollable,

as stressors often are, and just endured. Here's a typical comment: " Well,

I'm always a wreck, but the year before my 'fibro' began was the worst year

of my life. My husband lost his job and I had to go back to work full-time.

After a slow course, my mother died of cancer. I took care of her without

any help from my brothers. Then I discovered my teenager doing drugs. I

can't believe I made it through the year. "

A Message For Us All

With an estimated ten million people suffering fibromyalgia, the profound

effect of chronic stress on the body becomes almost self-evident. The

physical changes induced by stress are real, just as real as an ulcer or a

blocked coronary artery. Fibromyalgia is like heart disease in another way,

too. Remediation often involves lifestyle changes as well as medical help.

Who gets " cured " of fibromyalgia? The lawyer who walks away from her

eighty-hour workweek and takes a lesser-paying job at a bank (or becomes the

forest ranger she always wanted to be). The middle-aged empty nester who

finally throws her chronically unfaithful husband out of the house and

returns to the sculpting career she gave up 30 years earlier. The victim of

childhood sexual abuse who, through counseling and support, need not forgive

her abuser, but at least can move on with her life.

The actual mechanics of treating fibromyalgia are not that complicated.

Basically, recovery means recognizing the stressors and restoring the body's

systems. We rebuild the muscles, restore an exhausted adrenal and thyroid,

and strengthen the immune system. Some conventional medicines help, as do

some alternative therapies, each depending on the individual situation. I'll

discuss the details of treatment next month.

Edelberg, M.D. practices integrative medicine at American WholeHealth,

Lincoln Park Center, where he is Clinical Director.

[Guest guest]

I too suffer from fibromyalgia and it is a difficult thing to deal with ,your

sister is lucky to have your support and understanding . I was just recently

diagnosed although I have been suffering for awhile . As for me they are not

sure what caused it though there may be a link to Poor Indoor Air Quality at my

job , but it will be hard to prove as there are many " things that can trigger "

this dreadful disease. I can offer a web site where you maybe able to obtain

information , the one I have found to be most helpful is American Doctor.com ,

they offer much info and a support group I hope this helps.