WHERE DOES IT HURT?
Revealing trigger points and finding balance to combat fibromyalgia.
Though it was practically unheard of 30 years ago, today approximately 5 million Americans face a fibromyalgia diagnosis [1]. Fibromyalgia is defined as pain that distributes throughout the body and affects many muscles [1]. The American College of Rheumatology developed a list of several areas, often labeled trigger or pressure points, affected by fibromyalgia. If an individual experiences pain in 11 out of 18 of these areas over a certain amount of time (approximately 3 months), the diagnosis of fibromyalgia is considered. Examples of these trigger points include:
Occiput. Near the base of the skull.
Low cervical. The lower vertebra of the neck.
Trapezius. The neck, midback and upper back muscles between the shoulder blades.
Supraspinatus. Above the scapula spine near the spinal border.
Second rib. The insertion of the second rib.
Lateral epicondyle. The side of the elbow.
Gluteal. The upper and outer muscles of the buttocks.
Greater trochanter. The upper part of the thigh.
Knee. The middle of the knee joint.
Many patients are relieved to get any answer at all to explain their mysterious, yet nagging discomfort. Unfortunately, a fibromyalgia diagnosis fails to answer two major questions: 1) How it originated and 2) How to manage it. These should be at the top of the list of priorities for both doctor and patient.
Researchers have not been able to isolate a specific cause of fibromyalgia. Instead, patients are better served by looking at fibromyalgia as a complex set of symptoms. The pain, fatigue and poor sleep associated with fibromyalgia are most likely a summation of several problems, meaning the muscle spasms and tightness are probably a consequence of many factors out of balance in the body. Fortunately, the patient has direct control over many of these and can improve them immediately.
Start by improving your diet. Intake of refined sugar, sweets, baked goods, crackers and white potatoes, should be minimized. Focus on more fruits, vegetables and healthy proteins. Start with a solid nutrition foundation. Fruit and vegetable intake is critical for the health of the bowels. Hydration is a must to combat muscle pain, which may mean replacing that extra cup of coffee or soft drink with water. Patients with significant pain should target approximately 60 ounces of fresh water a day, unless directed otherwise.
Targeted nutrients can be a major benefit for fibromyalgia sufferers. Aching muscles need to be fed necessary nutrients to keep the muscles happy. Several supplements may be suggested, depending on the need of the patient, including:
Magnesium. Needed to help relax and strengthen the muscles; it also helps with constipation. 250–500 mg daily.
CoQ10. CoQ10 feeds the powerhouse of the cell, the mitochondria, which creates more energy. 100-200 mg daily, with food.
Fish oils. Useful for multiple body functions, fish oils can help with inflammation that may be aggravating the pain. 1,500-2,000 mg of EPA plus DHA daily.
Turmeric. Derived from the spice curry, turmeric has many anti-inflammatory benefits that may help with pain. 500 mg daily, with food.
Vitamin D. Dosing typically starts at 1,000-2,000 IU daily, with food. Also 10 minutes of sunshine (without burning the skin) is very important for adequate vitamin D.
A good multivitamin. Improves basic nutrition levels.
Hormones are chemical messengers that regulate multiple functions throughout the body. When hormone function declines, fatigue and weakness can become significant. Women with a history of fertility or cycle irregularities may encounter problems with progesterone, which could aggravate inflammation in the body. In men, low testosterone can contribute to fatigue (this can be a problem for women as well). The hormone DHEA may be low in fibromyalgia sufferers, leading to inflammation, worsening joint pain and mood changes. Cortisol hormone is anti-inflammatory and plays a role balancing blood sugar and energy. Thyroid function, as well as the levels of each of these hormones, should be monitored for their potential role in chronic symptoms of fibromyalgia.
If the body is not digesting and absorbing food and vitamins well, it will not be getting the building blocks needed to repair and rebuild itself. Constipation or very loose bowels could be an indication of poor digestion. Probiotics can help restore the good bacteria needed to help support the health of bowels and aid those prone to diarrhea. Magnesium and vitamin C are helpful for constipation. The dosages of either nutrient can be increased until the bowels become regular. Digestive enzymes taken during a meal can aid in the break down of food, which benefits the absorption of nutrients. Once the bowels are working properly, the body will be in a better position to heal.
A good night’s rest is also necessary for healing. Poor sleep several weeks to months in a row will certainly be a factor in fatigue and pain. Sleep issues may be due to difficulty falling asleep or staying asleep. Melatonin, a hormone made in the body and in supplement form, can help establish a deeper sleep for those suffering from interrupted rest. Patients typically start at 1 mg daily and can increase up to 3-6 mg if needed. It should be taken about 30-60 minutes before bed. Natural sleep aids include magnesium, calcium, L-theanine, meditation and yoga.
Fibromyalgia is no longer a chronic disease with no existing treatment. Dr. Jacob Teitelbaum has described this at length in his book, From Fatigued to Fantastic, a detailed resource outlining many of the points described above. Relief will come when you can finally find that balance of healthy bowels, hormones, sleep and nutrition.
Reference:
1. http://www.cdc.gov/arthritis/arthritis/fibromyalgia.htm
Other Trusted Sources:
Fibromyalgia Network
National Fibromyalgia Association
