A PRACTICAL APPROACH TO FIBROMYALGIA: NON-SCIENCE BASED THERAPEUTIC INTERVENTIONS (ALTERNATIVE MEDICINE)
Physicians do not have successful treatments for fibromyalgia, which has made this a very attractive area for alternative medicine providers who often claim to have successful treatments. Patients with fibromyalgia are more likely than the general population to seek out alternative medicine, with up to ninety one percent of these patients seeing alternative providers. Several therapies have become standard fare for the fibromyalgia patient seeking alternative care. The Internet has become a major source of information with over 100,000 sites showing up on an alta vista search. The following are some of the more common treatments that fibromyalgia patients use.
Elimination Diet-In order to identify and avoid “irritant” foods for which people may have a “subclinical” allergy, a rotation of foods with close attention to effects may be attempted. Specific foods are introduced into the diet at the rate of one per five days. An “oligo-antigenic” diet is another method of food therapy, whereby modern processed foods are removed from the diet and replaced with the paleolithic equivalents. viagra soft
Guaifenasin-This Internet based hypothesis posits that fibromyalgia is a “retention disease similar to gout, but with phosphate that has accumulated in the tissue. Since phosphate is a normal cation in the body there is no inflammation of the tissue. Guaifenasin and water taken in large doses is the treatment espoused here. A double blind placebo controlled study showed no benefit of this treatment at all Magnetic Therapy-A multi-level-marketing business that strives to convince people with fibromyalgia that they can “feel” electromagnetic fields. It is this electromagnetic sensitivity that throws people off balance and maintains the constant level of discomfort. The shiny magnets sold are usually no stronger or different than the ones we keep on our refrigerators, but as medical treatments, even without any monitoring of the effect that these magnets have on people, can cost hundreds of dollars.
Acupuncture-Oriental medical practitioners, who perform acupuncture, moxibustion and combine treatments with therapy to balance the body humors do well in treating this condition. In one study relief lasted for twenty months after acupuncture in 46% of patients, and sixty nine percent said that they were able to significantly reduce the medications they were taking while receiving acupuncture. However oriental medical providers consider acupuncture an adjunctive therapy and not as a curative or definitive treatment. Acupuncture may be effective because it has been noted to cause an increase in seratonin levels in the serum. canadian discount drugs
Ayurvedic Medicine-Indian health care philosophy based on a balance of physical and spiritual factors. Lifestyle changes are a key part of this treatment as well as gaining a mastery over ones environment by turning inward. Besides the harmonic balancing of elements (earth, air, fire, water, and ether), other expressions of this philosophy include purging, enemas and therapeutic vomiting.
Polarity Therapy-Works to balance the energy forces in the body to the environment surrounding it. Polarity workers redirect energy with crystals, touch or other modalities felt to have energy flow.
Zone Therapy (reflexology/iridology/auri-culotherapy)-Areas of the feet, hands, eyes, or ears are felt to have corresponding areas to the organs and body. Through manipulation of these zones healing is felt to occur in the corresponding body areas. Massage and pressure point treatment of these areas is done.
Pet Therapy-Give people a need outside of themselves. Pets do not listen to excuses and force people to be more scheduled and regimented. They also give love and caring to people who may have been abandoned by other friends and may not have adequate social support.
Herbal Therapy-Too many herbs claim benefit in fibromyalgia to review in this article.
SAM-e is currently in vogue. Treatments have included pycnogenol, teatree oil, valerian root, none juice and multiple other treatments. Explanations vary, studies on specific herbs are rare and the change in herbal treatment makes it difficult to complete studies before new mixtures are developed.
Education-Patients with fibromyalgia seem to be comforted once the diagnosis is confirmed by a healthcare professional. Much of what we can do is to “witness” the disease along with the patient. Even though we do not have successful treatments we can help people understand the disease process, what will worsen it, and how long the exacerbations will last. People also do better when they are given some part in their recovery. Relaxation and breathing exercises can be used to help a person maintain their functional ability at work. There also is benefit in “uncoupling” of the sensory component of the pain and the cognitive appraisal of the pain.
Exercise-As muscles atrophy, the pain worsens and prospects for full recovery diminish. Maintaining muscle tone needs to be a priority in treating fibromyalgia. Exercise programs need to start off with stretching. Exercises should be low load, low repetition and focus on strengthening. If aerobics are done they should be low impact. Pain limits should not be exceeded, and when pain develops exercise should stop. Water aerobics are particularly well tolerated.
Biofeedback-There are a number of studies that show biofeedback successfully lessening the number of tender points, decreasing overall pain and decreasing morning stiffness. Effects of biofeedback have been shown to last up to six months after treatment has been instituted. buy viagra uk
Hypnosis-Hypnosis has shown promise in relieving pain symptoms. Hypnosis was shown to be more effective than physical therapy in relieving pain in a controlled study of 40 patients with fibromyalgia.
Physical Therapy Modalities-Heat, stretching, massage, meditation, body work, can all be used to maintain the functional ability of a person with fibromyalgia. It does not help in curing the condition or alleviate the return of symptoms. The goal of these treatments is to minimize fatigue and maintain functional ability.
Manipulation-People with fibromyalgia both subjectively and objectively have been shown to benefit from manipulation. Counterstrain is the technique of choice. Specific goals need to be set. In my practice if, after an initial weekly treatment for three weeks, the positive response does not last at least two weeks, I discontinue manipulation. Almost all patients feel better for some short period of time ranging from 3 hours to 3 days. If the response does not last, then the effect is not alleviating the underlying pathology of the disorder.
Cognitive Behavioral Therapy-Focuses mainly on relaxation and coping strategies.. There are strong positive reinforcements for healthy behaviors. Compliance with this therapy has been poor.
Tricyclic antidepressants-Low doses of ami-triptyline and trazodone have been shown to help with sleep, but have minimal effect of the pain symptoms.. Initial dose of amitriptyline is 10 mg given at bedtime. Patients should be warned that these medications do cause a “hun-gover” feeling particularly for the first week of use. Symptom improval may take 4-6 weeks and a course of at least three months should be tried before a full evaluation of the therapy can be done. tadalis sx
SSRI-Fluoexetine is the most widely studied and has some benefit in treatment. An adequate trial of this medication is a minimum of two months.
Seratonin/Norepi Reuptake Inhibitor-Ven-lafaxine is the only medication in this class and at high doses it does increase norepi and dopamine levels in the serum. Anecdotally it has been very successful, but no double blind trials have been conducted yet.
Benzodiazepines-When used in combination with NSAIDS have shown benefit in reducing pain. The chronic nature of fibromyalgia makes benzodiazepines a difficult medication to choose. Dependence to benzodiazepines and withdrawal syndromes need to be taken into consideration before instituting treatment.
Analgesics-Tramadol in injectable form has been shown to be as effective as acetaminophen with codeine for treatment of pain without the side effect and abuse problem. Goal oriented and time limited therapies can be of tremendous benefit and need to be included in the treatment algorithms.
Calcitonin-nasal administration of calcitonin has been shown to decrease pain. Calcitonin is a seratonin precursor.
Muscle Relaxants-Cyclobenzaprine (flexeril) has been shown to help a person maintain stage four sleep and wake up more rested. A five mg dose 1-2 hours before bedtime. It has also been shown to reduce pain particularly in the late evening.
Opiods-Effective pain relievers but potentially dangerous medications to be using in fibromyalgia. When used they need to be given for a specific time period and with the use of them directed at achieving a specific goal. May increase fibrofog. buy tadacip
Steroid injections into trigger points-This therapy has been shown to increase a persons functional ability by increasing range of motion. There are also small decreases in pain perception after the injection.