Chronic Pain and Pain Relief

By Bonnie Jenkins, Advanced Natural Medicine

Imagine suffering from intense pain – pain that wasn’t limited to just one area, but encompassed your whole body. Imagine waking up in the morning so exhausted that you just can’t function. Now, imagine your doctor telling you that everything is fine and that it’s “all in your head.”

That’s what my friend Margaret went through after she had been involved in an automobile accident. All told, she saw 37 doctors and underwent more x-rays and blood tests than she could count. But the message was always the same – “there’s nothing wrong with you.”

Margaret was about to give up when I suggested that she see a friend of mine – an integrative physician that specializes in autoimmune conditions. After just one visit, during which she told the doctor about her symptoms and underwent a physical exam which included checking for tender points, Margaret had her diagnosis – fibromyalgia.

The Mystery Malady

For decades, doctors didn’t believe fibromyalgia was real – a lot of them still don’t – largely because there isn’t any physical evidence. Blood tests don’t reveal a disease or infection. X-rays won’t show an injury, worn joints or pinched nerves. So, without a smoking gun, they came to the conclusion that the problem was purely psychological – which wasn’t much of a leap for these predominantly male doctors since fibromyalgia affects mainly women. And, since medical science has historically considered women second-class citizens, it’s no surprise that most doctors figured that these were simply crazy women starved for attention.

But if you suffer from fibromyalgia, you know it’s all too real – your muscles and joints ache and burn, you’re drained of energy, you can’t concentrate and getting a good night’s sleep is next to impossible. In other words, you feel like you’ve been run over by a Mack truck. If that weren’t enough, many people with fibromyalgia also suffer from other symptoms as well, including irritable bowel syndrome, migraines, jaw pain and chemical sensitivities.

But the most debilitating aspect of fibromyalgia is the pain. A recent Newsweek article put it this way: “In fibromyalgia, sensory messages to the brain are intensified, making even a warm bubble bath feel like torture.”

Finally, however, fibromyalgia sufferers may get some vindication. A study conducted last year at the National Institute of Dental and Craniofacial Research used Magnetic Resonance Imaging (MRI) to document the brain changes fibromyalgia patients experience during pain. Sixteen people with fibromyalgia and sixteen healthy volunteers subjected themselves to an MRI while researchers applied a small amount of pressure to their left thumbs. In the fibromyalgia group, blood rushed to areas of the brain involved in pain perception. But no changes were seen in the brains of the healthy volunteers. The researchers had to double the pressure on them to elicit the same response that they saw in the fibromyalgia group.

Other studies have found that people with fibromyalgia have three times more of a pain-transmitting chemical called substance P in their spinal fluid and too little of the pain-reducing neurotransmitters serotonin and norepinephrine.

But, while it’s nice to have proof that you really are sick, for patients now struggling with debilitating symptoms, it’s not much comfort.

Trial and Error

When it comes to relieving the pain and fatigue that mark fibromyalgia, conventional medicine doesn’t have a lot to offer. Treatment commonly involves antidepressants like Prozac or Zoloft to diminish the pain and improve sleep. Many doctors also suggest using an over-the-counter NSAID like aspirin or ibuprofen. But a double-blind trial didn’t find any difference between ibuprofen and a placebo for treating fibromyalgia.

So it’s no surprise that many people have turned to alternative treatments – often with great success. But, since fibromyalgia can bring on different symptoms in different people, finding the right treatment often involves some trial and error.

Since serotonin levels are low in people with fibromyalgia, 5-HTP may help to increase this critical neurotransmitter. 5-HTP is a serotonin precursor that is absorbed by the brain and quickly converted into serotonin. The result is a reduction in depression, insomnia and pain. In two 50-patient trials, researchers gave patients 100 mg. of 5-HTP three times a day. As a result, most of the subjects experienced a 50 percent reduction in all symptoms measured. In fact, the 5-HTP was so effective that the study participants retained the benefits for up to 90 days after treatment.

A combination of magnesium and malic acid may also offer relief from pain and fatigue. In one study, researchers from the University of Texas studied the effects of magnesium and malic acid on 24 fibromyalgia subjects who were enrolled in a placebo-controlled four-week trial. Each patient received three tablets that contained 200 mg. of malic acid and 50 mg. of magnesium twice a day. At the end of the trial, no significant improvement was noted. However, during a follow-up six-month open trial with doubled doses (six tablets, twice daily), researchers noted a significant reduction in pain and tenderness, plus improved psychological scores.

One popular remedy to clear the mental fuzziness that often accompanies flare-ups is CoQ10. In one study, British physician Robert Lister used a combination of CoQ10 and ginkgo biloba to treat 25 people with fibromyalgia. Dr. Lister asked the subject to take the combo (200 mg. of CoQ10 and 200 mg. of ginkgo) for 84 days. Clinical changes were recorded with a questionnaire designed to track fibromyalgia symptoms. Throughout the study, 64 percent of the participants experienced a progressive and significant improvement in their quality of life.

One Last Thing ...

While supplements can help relieve some symptoms, real relief requires a whole body approach. A vegan diet (no meat or dairy) that is also low in salt may help. In a controlled clinical trial, women with fibromyalgia were put on a special diet consisting only of raw foods - fruits, vegetables, nuts, seeds, legumes and cereals. The diet also contained several fermented foods, including a fermented yogurt-food made from oats, a fermented beverage made from wheat berries (called Rejuvalac) and several types of fermented vegetables, particularly cabbage. During the three-month trial, the women following the therapeutic diet experienced a significant reduction in body weight, pain, the use of painkillers, depression and the number of sore fibromyalgia points, compared with those who continued to eat their regular diet.

But, even if you don’t go the vegan route, it’s important to avoid refined foods like sugar and white flour, food additives like aspartame and MSG, and caffeine. Not only are they devoid of nutrients, these foods can actually make conditions worse.

There have also been reports that regular low-intensity exercise can improve fibromyalgia symptoms. In one controlled trial, a program consisting of two 25-minute exercise classes plus two educational sessions per week for six weeks resulted in an immediate and sustained improvement in walking distance, fatigue, and well-being in a group of people with fibromyalgia. But the participants didn’t experience a reduction in pain, anxiety or depression.

A lot of fibromyalgia patients I’ve talked to admit that exercise is one of the hardest recommendations to follow – mainly because of the pain and lack of energy. But, there just might be an easier way. In a more recent controlled trial, a 35-minute exercise program in a warm pool once a week for six months led to improvements in hand-grip strength and endurance, as well as a reductions in pain, distress, depression and anxiety. Exercising in water provides all the benefits of a normal exercise routine without putting pressure on your joints and muscles. Unless your fibromyalgia is so severe that even water hurts, this is a terrific way to exercise. And classes are widely available. Check with your local community center or health club to find an underwater exercise program in your area.

This Just In ...

For years, people living near power lines have worried about the cancer risk associated with electromagnetic fields (EMF). And for years, the government has told them there was little evidence that there was a link between the two. But now there is.

A new study in the American Journal of Epidemiology has concluded that there is indeed cause for concern – especially for men. In the study, researchers from the University of North Carolina-Chapel Hill examined data from 387 former employees of five large utility companies in the US who had died from prostate cancer. The findings showed that men with the highest EMF exposure – typically those living near power lines – were twice as likely to die from prostate cancer.

This may just be the tip of the iceberg. Earlier studies have found some evidence that EMFs may be tied to childhood leukemia, but the results weren’t consistent. But these independent studies are few and far between – mainly because powerful industry groups aggressively work to stifle negative findings that could impact profit margins.

While government and industry still insist that exposure to EMFs aren’t a health threat, you can take matters into your own hands. If you’re stuck living close to power lines, it might be wise to start a proactive nutritional program centered around potent cancer fighters, including antioxidant vitamins, green tea and turmeric.

***

References:

Gracely RH, et al. “Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia.” Arthritis and Rheumatism. 2002; 46:1333-1343.

Juhl JH. “Fibromyalgia and the serotonin pathway.” Alternative Medicine Review. 1998; 3:367-375.

Lister RE. “An open, pilot study to evaluate the potential benefits of coenzyme Q10 combined with Ginkgo biloba extract in fibromyalgia syndrome.” Journal of International Medical Research. 2002; 30:195-199.

“Powerlines and prostate cancer.” Health Media Ltd. 1 Aug 2003.

Russell IJ, et al. “Treatment of fibromyalgia syndrome with Super Malic: a randomized, double blind, placebo controlled, crossover pilot study.” Journal of Rheumatology. 1995; 22:953-958.