Understanding

Fibromyalgia:
A Holistic Approach to Chronic
Pain and Fatigue
1
It is estimated that Fibromyalgia
affects (at least) six million
Americans; (at least) four million of
which are women.
The condition may be seen at any
age, although it occurs most
frequently during midlife.
Source: Soderberg, S., Norberg, A., “Metaphorical Pain Language Among Fibromyalgia Patients,” Scan J. Caring Sci., 1995, 9: 55-
59. 2
Fibromyalgia is a
complicated condition.
Many physicians who are
not familiar with this
disorder feel there are no
clear-cut answers.
However, people need
effective relief, support
and guidance.
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 Therefore, the purposes of
tonight’s talk are:
1. To provide some true facts about
Fibromyalgia,
2. Help you to make an informed
decision about the various natural
ways to help alleviate Fibromyalgia, or
Fibromyalgia-like discomfort.
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Here is how the word
Fibromyalgia breaks down:
FIBRO: from fiber or fibrous – tissues
which are the soft tissues of the body
under the skin, especially around the
joints, including tendons.

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MY: from myo – meaning muscle.

ALGOS: from algia – meaning pain.

IA: meaning state of, or condition.

Source: Dorland’s Pocket Medical Dictionary, 1989, 24th Edition.

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Fibromyalgia simply
means a condition
which is character-
ized by pain in the
muscle and soft
tissue fibers of the
body.
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Incidence of Fibromyalgia:
• It is the third most prevalent
rheumatologic disorder (after
osteo-arthritis and rheumatoid
arthritis).
• Represents 5% of family practice
office visits and 20% of rheumatism
visits.
Source: Cox, James, M., Low Back Pain: Mechanism, Diagnosis and Treatment, Chapter 7, pg. 251
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Incidence of Fibromyalgia:
• Approximately 90% of Fibromyalgia
patients are women between the ages of 40
and 60 years (average age: 49).

• Of the 10 to 20% of cases that affect

males, the presentation (of symptoms and
care of), is no different than that for
women.
Source: Ibid.
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According to respected
rheumatologist, Dr.
Frederick Wolfe, author of
Diagnosis of Fibromyalgia,
there is a great deal of
misdiagnosis occurring,
especially a tendency to use
Fibromyalgia as a
‘wastebasket diagnosis.’
Source: Wolfe, F., Diagnosis of Fibromyalgia, J. Musculoskeletal Med 1990: 7(7): pp. 53-69.

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“Anyone with widespread and/or poorly
localized musculoskeletal pain without
signs of an actual disease are just
lumped into the general category of
Fibromyalgia by their medical
physician. This is very unfortunate and
also very avoidable.”
Source: Bennett, R.M., Myofacial Pain Syndromes and Fibromyalgia Syndrome: A Comparative Analysis. Man Med 1991; 6(1): pp. 34-45
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People with Fibromyalgia will experience
widespread pain of at least three months
duration.
Some people are often
unable to continue in
certain kinds of work
due to this widespread
pain.

Source: Op cit (Wolfe, F.)

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Other Symptoms Include:

• Chronic fatigue (physical or mental)

• Tiring easily
• Morning stiffness
• Urinary urgency
• Anxiety or stress
Source: Op cit (Wolfe, F.)
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Other Symptoms Include:

• Irritable Bowel Syndrome

• Sleep disturbance
• Tingling and numbness
• Excessive menstrual bleeding
• Gastrointestinal symptoms
Source: Op cit (Wolfe, F.)
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Approximately 75% of
Fibromyalgia sufferers
experience sleep
disturbance which can
range from insomnia to
wakefulness, to non-
restorative sleep.
The discomfort will be
aggravated by extremes in
temperature as well as
humidity.
Source: Ibid (Wolfe, F., and Bennett, R.M.), as well as: Duarte, M., “Primary Fibromyalgia Syndrome and Myofacial Pain Syndrome: Clinical Features and Criteria for Diagnosis.
Chiro Tech 1989; 1(3): pp. 97-100. 14
Please fill out the
survey so you can
see if the types of
symptoms you
have are related
to Fibromyalgia.

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 Characteristic Symptoms of
Fibromyalgia and their
Prevalence (Pain Symptoms)
Widespread Pain 98%
Neck 85%
Low Back 79%
Mid Back 72%
Source: Op cit (Wolfe, F., and Bennett, R.M.)
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 Characteristic Symptoms of
Fibromyalgia and their
Prevalence (Pain Symptoms)
15 or More Painful Sites 56%
Headaches 53%
Difficulty with Menstruation 41%

Source: Op cit (Wolfe, F., and Bennett, R.M.)

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People with
Fibromyalgia will
also have tender
points at several
locations on their
body.

Source: Op cit. Modified from Wolfe, F., et al, by the American College of Rheumatology.
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If you experience tenderness in any
number of these locations, it may
indicate that you are suffering from
Fibromyalgia.
Only by being examined by a trained
physician, can the diagnosis be
properly made.
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The following
trigger points of
Fibromyalgia
appear in this
diagram in
order of
frequency.
Source: Sabley, B.J., “Malic Acid and Magnesium for Fibromyalgia and Chronic Pain Syndrome, 1999, p. 16.
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A Chiropractor, because he or she
works with their hands, can
recognize and detect these tender
points in a
person’s body.

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There are two possible approaches
to treating Fibromyalgia:
1. Drug-free approach (natural
therapies support the body’s innate
ability to heal itself.)
2. Drugs such as: Elavil®, Endep®,
Flexeril®, Prozac®, Paxil®, Zoloft®,
Advil®, Motrin®, Aleve®, etc.
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Elavil®, Endep®, and
Flexeril® are widely used
at night to modulate sleep
disturbance, however it
appears that in long-term
therapy the benefits may
be lost and the side effects
are often daunting.
Source: Op cit (Cox).
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Nonsteriodal anti-inflammatory drugs
such as Motrin®, Aleve®, Advil®,
Ibuprofen, etc.,
are often not sufficient
to relieve the aching
and discomfort.
Drugs only mask
the symptoms.
Source: Campbell, S.M., Gatter, R.A., Clark, S., et al. A Double-Blind Study of Cyclobenzaprine versus Placebo in Patients with Fibrositis
[Abstract], Arthritis Rheumatology 1986; 29: pg. 1371. 24
There is strong doubt in the use of
pharmaceuticals in the treatment of
Fibromyalgia because of an overall
poor performance, and side effects
showing no improvement in 56.6% of
patients using Elavil®.
Also no improvement in [at least]
46.3% of patients using Flexeril.
Source: Wolfe, F., The Clinical Syndrome of Fibrositis. American Journal of Medicine, 1986, 81 (suppl 3A): pp. 7-14.

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The cause of Fibromyalgia
symptoms include:
• Trauma or stress
• Irritated nerves
• Lack of exercise
• Nutritional deficiencies
• Or toxicity
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A multifaceted health care
and treatment plan (such
as exercise therapy, stress
reduction, nutrition and
Chiropractic care) has
shown the most promise
for Fibromyalgia sufferers.
Source: Op cit. (Cox)
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Let’s take a look a the following
natural approaches which have
proven to be effective in handling
the problem of
Fibromyalgia.

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 1. Exercise
Research has
indicated that more
than 80% of
patients with
Fibromyalgia are
not physically fit.
Source: Goldman, J.A., “Hypermobility and Deconditioning: Important Links to Fibromyalgia/Fibrositis,” South Med J 1991; 84: 192-1196
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Although it is
understandable that
Fibromyalgia
patients do not want
to exercise because
of fatigue and pain,
if they do so, the
prognosis is greatly
improved.
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Cardiovascular
exercises are, by far,
considered most
effective and should
be included in any
treatment program.
Source: Wigles, S., Stiles, T., “Effects Aerobic Exercise versus Stress Management Treatment.” Scandinavian Journal of Rheumatology. 1996; 25: pp. 77-86.
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A recent study followed
40,000 post-menopausal
women for seven years.
Those who regularly
engaged in moderate
activities had a 41%
longer life-span than
those who did no exercise.
Source: Journal of the American Medical Association, as featured in Consumer Reports on Health, April 1998.
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A seven-year study by the University
of Minnesota involving 12,000 men
found that those who walked or did
similar exercise for an average of just
20 minutes a day were 37% less
likely to die of coronary disease than
those who exercised less than that.
Source: Consumer Reports on Health, April 1998.
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2. Stress Reduction
Many Fibromyalgia
patients remember a
specific triggering event
association with an
abrupt onset of the
symptoms of
Fibromyalgia.
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These events often
include physical stress
(such as an illness or a
virus) or emotional
stress (such as marital
difficulties, loneliness,
job dissatisfaction,
boredom, lack of
purpose in life, etc.)
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What are some
things you can do
naturally to reduce
the harmful effects
of stress?
• Take a walk
• Laugh more
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California State
University found that a 10
minute walk is enough to
increase energy, alter
mood and affect a positive
outlook for up to 2 hours.
31 million people walk for
exercise on a regular
basis.
Source: Stress: 63 Ways to Relieve Tension and Stay Healthy. Inlander, Charles, B., and Moran, Cynthia, pg. 45.
37
Researchers at Loma
Linda University showed
that comedy lowers the
body’s level of stress,
thereby lowering blood
pressure and increasing
white blood cells and one’s
immunity.
Source: Op cit (Inlander and Moran).
38
A study reprinted in the July/August
1995 issue of Men’s Health showed
toddlers laugh 400 times a day while
adults only
laugh 15 times.

Source: Ibid.
39
3. Nutrition and Diet

The use of malic acid with

magnesium was beneficial in the
treatment of Fibromyalgia, as tested
in a double-blinded study.

Source: Russell, I.J., Michalek, J.E., Flechas, J.D., et al. Treatment of Fibromyalgia Syndrome with Super Malic: A Randomized Double-Blind, Placebo Controlled, Cross-Over Study. Journal
of Rheumatology, 1995; 22() pp. 953-958.
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Vitamin E has long been suggested
for rheumatic disorders and would
help Fibromyalgia as well.

Source: Steinberg, C.L., The Tocophorols (Vitamin E) in the Treatment of Primary Fibrositis. J Bone Joint Surg 1942; 24 (2): pp. 411-423.
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Other nutrients to consider are:
•Vitamin B6 to support the
aluminum detoxification process,
•Manganese to support neuro-
endocrine changes
•Thiamin to support the
respiratory functions.
Source: Percival, Mark, “Fibromyalgia: Nutritional Support,” Clinical Nutrition Insights, 1997, pg. 3.
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4. Toxicity
Aluminum toxicity may play a role in
symptoms experienced by
magnesium deficient Fibromyalgia
patients. Magnesium is required by
the body to help block the toxic
effects of aluminum.
Source: Sabley, Billie, J., Ph.D., Malic Acid and Magnesium for Fibromyalgia and Chronic Pain Syndrome, 1999, pg. 11.
43
Malic acid can act as a most
potent aluminum detoxifier
and is especially effective at
decreasing aluminum toxicity
in the brain.
Source: Ibid.
44
Where does aluminum toxicity
come from?
• Aluminum cookware
• Aluminum soda/beverage cans
• Table/restaurant salt (has
sodiumsilico aluminate)
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Where does aluminum toxicity
come from?
• Substances that contain aluminum
byproducts, such as antacids and
baking soda
• Underarm deodorants (often contain
aluminum chlorohydrateor
aluminum zirconium
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Toxic habits that
contribute to poor
overall body
efficiency include:
smoking tobacco, the
ingestion of coffee,
soft drinks, alcohol…
Source: Goldberg, Paul A., “Fibromyalgia: Understanding It’s Causes and Resolutions”, Today’s Chiropractic, May/June 1998, pg. 88.
46
… and a variety of prescription and
non-prescription drugs.

Source: Ibid.
47
5. Nerve pressure reduction
through spinal manipulation
Specific re-alignment of
the spine to reduce
pressure on the nerves is
called an adjustment.

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In his article, The Clinical Syndrome
of Fibrositis, Dr. Frederick Wolfe,
M.D., states:
“Most patients with Fibromyalgia who
have received Chiropractic
adjustments reported moderate to
great improvement.”
Source: Wolfe, F., “The Clinical Symdrome of Fibrositis,” Am Journal Med 1986; 81 (Supple 3A), pp. 7-14
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In a study reported in the American
Journal of Physical Medicine
Rehabilitation, Chiropractic care
scored among the most effective
measures.
This is noteworthy as it shows
Chiropractic care is more effective
than drugs.
Source: Waylouis, W.G., Heck, W., “Fibromyalgia Syndrome: New Associations,” Am Journal Phys Med Rehabilitation, 1992; 71: pp. 343-348.
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Chiropractors, because of their
education in the areas of spinal
manipulation, adjustments,
nutrition, trigger point therapy,
and exercise, as opposed to drug
therapy, are ideally suited for the
management of this disorder.
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Doctors of Chiropractic
are uniquely suited to
address the management
and treatment of this
difficult syndrome, and
they may have the means
to afford the Fibromyalgia
sufferer the greatest relief
of any health care
provider.
Source: Op cit, Cox.
52
To reduce the harmful effects of
Fibromyalgia and similar symptoms,
treatment should include
Chiropractic
adjustments of the
spine including
trigger point
therapy…
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…Moderate
cardiovascular
exercise and
stretching…

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…Nutritional intervention…

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…Rest and stress reduction.

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A gift

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