| | | | Other Names | | | Fibromyalgia, FMS, Fibrositis, Musculoskeletal Pain.
View products
| | | Also known as: Fibromyositis, Fibrositis, Myofascial Pain Syndrome,
Myofibrositis, Primary Fibromyalgia Syndrome.
Fibromyalgia is a
complex syndrome with no known cause or cure. Its predominant symptom is
pain in the fibrous tissues, muscles, tendons, and ligaments, although
other symptoms may be experienced. Research has demonstrated that the axis
connecting the three glands primarily responsible for the stress response
(hypothalamus, pituitary, adrenals) may be dysfunctional in people with
fibromyalgia.1 Inflammation of the involved structures is generally absent
in fibromyalgia.
Of the estimated three to six million people2
affected by this disorder in the United States, the vast majority are
women between 25 and 45 years of age.
What are the symptoms of
fibromyalgia? Trigger-point pain at characteristic locations is the
defining symptom of fibromyalgia. The most commonly affected locations are
on the occiput (nape of the neck), the neck itself, shoulders, trunk, low
back, and thighs. Other symptoms may also be experienced, including
fatigue, chest pain, low-grade fever, swollen lymph nodes, insomnia,
frequent abdominal pain, irritable bowel syndrome, and
depression.3
Conventional treatment options: Treatment commonly
involves a combination of medications, including one of several
antidepressants, to diminish pain and improve sleep (e.g., amitriptyline
[Elavilr], cyclobenzaprine [Flexerilr], fluoxetine [Prozacr], sertraline
[Zoloftr], paroxetine [Paxilr], and fluvoxamine [Luvoxr]). Low-impact
exercise programs to improve aerobic fitness, stretching techniques to
ease muscle tension, and cognitive therapy for coping with stress and
emotional disorders are also included in conventional treatments. Numbing
medicine can be sprayed onto or injected into trigger points to assist
muscle stretching. Oral pain relievers, such as aspirin (e.g., Bayerr),
ibuprofen (e.g., Advilr), and acetaminophen (Tylenolr), may also be
recommended. However, one double-blind trial found no difference between
ibuprofen and placebo with respect to treating fibromyalgia
symptoms.4
Dietary changes that may be helpful: A vegan diet
(includes no animal products) that is also low in salt may help women with
fibromyalgia. In a controlled clinical trial,5 women with fibromyalgia
were put on a special diet consisting only of raw foods-primarily fruits,
vegetables, nuts, seeds, legumes, and cereals (such as rolled oats). 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, women following the
therapeutic diet experienced a significant reduction in body weight, pain,
morning sickness, use of painkillers, depression, and the number of sore
fibromyalgia points, compared with those who continued to eat their
regular diet. Due to the liberal use of nuts and seeds, this diet was not
low in fat; for example, 31% of all calories came from fat. Nonetheless,
the total number of calories was relatively low (less than 1,900 calories
per day), which was probably responsible for the decrease in body
weight.
Lifestyle changes that may be helpful: Low-intensity
exercise may improve fibromyalgia symptoms. People with fibromyalgia who
exercise regularly have been reported to suffer less severe symptoms than
those who remain sedentary.6 7 8 In a controlled trial, a program
consisting of two 25-minute exercise classes plus two educational sessions
per week for six weeks resulted in immediate and sustained improvement in
walking distance, fatigue, and well-being in a group of people with
fibromyalgia;9 however, no reductions in pain, anxiety, or depression were
seen. In a more recent controlled trial, a 35-minute exercise program in a
warm pool once a week for six months, coupled with counseling sessions,
led to improvements in hand-grip strength and endurance, as well as to
reductions in pain, distress, depression, and anxiety.10 The results of
this trial, and other similar trials, suggest that underwater exercise
training, in combination with a counseling intervention, should be
considered by people with fibromyalgia.
Nutritional supplements
that may be helpful: People with fibromyalgia often have low serotonin
levels in their blood.11 12 13 Supplementation with 5-HTP may increase
serotonin synthesis in these cases. Both preliminary14 15 and double-blind
trials16 have reported that 5-HTP supplementation (100 mg three times per
day) relieves some symptoms of fibromyalgia.
Some studies have
found low vitamin B1 (thiamine) levels and reduced activity of some
thiamine-dependent enzymes among people with fibromyalgia.17 18 The
clinical significance of these findings remains unknown.
One early
preliminary study described the use of vitamin E supplements in the
treatment of "fibrositis"-the rough equivalent of what is today called
fibromyalgia. Several dozen individuals were treated with vitamin E using
amounts ranging from 100-300 IU per day. The results were positive and
sometimes dramatic.19 Double-blind trials are needed to confirm these
preliminary observations.
Intravenous S-adenosylmethionine (SAMe)
given to people with fibromyalgia reduced pain and depression in two
double-blind trials;20 21 but no benefit was seen in a short (ten-day)
trial.22 Oral SAMe (800 mg per day for six weeks) was tested in one
double-blind trial and significant beneficial effects were seen, such as
reduced pain, fatigue, and stiffness, and improved mood.23
A
preliminary trial found that a combination of magnesium and malic acid
might lessen muscle pain in people with fibromyalgia.24 The amounts used
in this trial were 300-600 mg of elemental magnesium and 1,200-2,400 mg of
malic acid per day, taken for eight weeks. A double-blind trial by the
same research group using 300 mg magnesium and 1,200 mg malic acid per day
found no reduction in symptoms, however.25 Though these researchers
claimed that magnesium and malic acid appeared to have some effect at
higher levels (up to 600 mg magnesium and 2,400 mg malic acid), the
positive effects were not demonstrated under blinded study conditions.
Therefore, the evidence supporting the use of these supplements for people
with fibromyalgia remains weak and inconclusive.
Melatonin
supplementation may be useful in the treatment of fibromyalgia. In a
preliminary trial, 3 mg of melatonin at bedtime was found to reduce tender
points and to improve sleep and other measures of disease severity, though
pain and fatigue improved only slightly.26
Are there any side
effects or interactions? Refer to the individual supplement for
information about any side effects or interactions.
Other
integrative approaches that may be helpful: Stress is believed by some
researchers to be capable of aggravating fibromyalgia symptoms.
Stress-reduction techniques, such as meditation, have proven helpful in
preliminary research.27
Acupuncture may be useful for short-term
relief of fibromyalgia symptoms. In one preliminary trial, acupuncture
produced a significant decrease in pain and point tenderness along with
related biochemical changes measured in the fibromyalgia patients'
blood.28 Another uncontrolled trial used electroacupuncture (acupuncture
with electrical stimulation) treatment in people with fibromyalgia who
were unresponsive to conventional medical therapies. After an average of
seven treatments per person, 46% claimed that electroacupuncture provided
the best relief of symptoms when compared to all other therapies, and 64%
reported using less medication for pain relief than prior to
electroacupuncture.29 A double-blind trial compared fake acupuncture to
electroacupuncture and reported significant differences in improvement in
five of eight outcome measurements among people with fibromyalgia.30
Short-term pain reduction in people with fibromyalgia has been reported in
other studies, some of which were at least partially controlled; however,
long-term benefits have never been investigated in a controlled clinical
trial.31 Long-term controlled trials are necessary to conclusively
determine whether acupuncture is a useful treatment for
fibromyalgia.
Joint manipulation, chiropractic, and related
treatments may be helpful for relieving some of the symptoms of
fibromyalgia. A preliminary study32 found that almost half of people with
fibromyalgia who received chiropractic care had "moderate to good"
improvement. A small preliminary trial33 evaluated the effect of four
weeks of chiropractic treatment (three to five times per week) consisting
of soft tissue massage, stretching, spinal manipulation, and general
advice and information. Treatment resulted in a significant decrease in
pain and an increase in range of neck movement, but there was no
improvement in tender points or in ability to function in daily life.
Another preliminary trial34 evaluated a longer treatment period (30
sessions) consisting of spinal manipulation and deep pressure massage to
tender points in the muscles. More benefit was reported by this study, as
60% of the patients experienced significant pain reduction, reduced sensed
of fatigue, and improved sleep. These benefits persisted one month after
the treatment was completed. People who did not feel better after 15
treatments were not likely to benefit from this type of treatment. No
controlled research has evaluated manipulation therapies for
fibromyalgia.
References:
1. Griep EN, Boersma JW,
Lentjes EG, et al. Function of the hypothalamic-pituitary-adrenal axis in
patients with fibromyalgia and low back pain. J Rheumatol
1998;25:1374-81.
2. Anonymous. Is fibromyalgia caused by a
glycolysis impairment? Nutr Rev 1994;52(7):248-50.
3. Wolfe F, Ross
K, Anderson J, Russell J. Aspects of fibromyalgia in the general
population: Sex, pain threshold, and FM symptoms. J Rheumatol
1995;22(1):151-5.
4. Yunus MB, Masi AT, Aldag JC. Short term
effects of ibuprofen in primary fibromyalgia syndrome: a double blind,
placebo controlled trial. J Rheumatol 1989;16(4):527-32.
5.
Kaartinen K, Lammi K, Hypen M, et al. Vegan diet alleviates fibromyalgia
symptoms. Scand J Rheumatol 2000;29:308-13.
6. Wilke W.
Fibromyalgia: Recognizing and addressing the multiple interrelated
factors. Postgrad Med 1996;100(1):153-70.
7. Carette S.
Fibromyalgia 20 years later: What have we really accomplished? J Rheumatol
1995;22(4):590-4.
8. Mengshail AM, Komnaes HB, Forre O. The effects
of 20 weeks of physical fitness training in female patients with
fibromyalgia. Clin Exp Rheumatol 1992;10:345-9.
9. Gowans SE,
deHueck A, Voss S, Richardson M. A randomized, controlled trial of
exercise and education for individuals with fibromyalgia. Arthritis Care
Res 1999;12:120-8.
10. Mannerkorpi K, Nyberg B, Ahlmen M, Ekdahl C.
Pool exercise combined with an education program for patients with
fibromyalgia syndrome. A prospective, randomized study. J Rheumatol
2000;27:2473-81.
11. Fava M, Rosenbaum JF, MacLaughlin R, et al.
Neuroendocrine effects of S-adenosyl-L-methionine, a novel putative
antidepressant. J Psychiatr Res 1990;24:177-84.
12. Bell KM, Potkin
SG, Carreon D, Plon L. S-adenosylmethionine blood levels in major
depression: changes with drug treatment. Acta Neurol Scand
1994;154(suppl):15-8.
13. Bell KM, Potkin SG, Carreon D, Plon L.
S-adenosylmethionine blood levels in major depression: changes with drug
treatment. Acta Neurol Scand 1994;154(suppl):15-8.
14. Puttini PS,
Caruso I. Primary fibromyalgia syndrome and 5-hydroxy-L-tryptophan: a
90-day open study. J Int Med Res 1992;20:182-9.
15. Moldofsky H,
Warsh JJ. Plasma tryptophan and musculoskeletal pain in non-articular
rheumatism ("fibrositis syndrome"). Pain 1978;5:65-71.
16. Caruso
I, Sarzi Puttini P, Cazzola M, Azzolini V. Double-blind study of
5-hydroxytryptophan versus placebo in the treatment of primary
fibromyalgia syndrome. J Int Med Res 1990;18:201-9.
17. Eisinger J,
Zakarian H, Plantamura A, et al. Studies of transketolase in chronic pain.
J Adv Med 1992;5:105-13.
18. Eisinger J, Bagneres D, Arroyo P, et
al. Effects of magnesium, high energy phosphates, piracetam, and thiamin
on erythrocyte transketolase. Magnesium Res 1994;7(1):59-61.
19.
Steinberg CL. The tocopherols (vitamin E) in the treatment of primary
fibrositis. J Bone Joint Surg 1942;24:411-23.
20. Tavoni A,
Jeracitano G, Cirigliano G. Evaluation of S-adenosylmethionine in
secondary fibromyalgia: A double-blind study. Clin Exp Rheumatol
1998;16:106-7 [letter].
21. Tavoni A, Vitali C, Bombardieri S, et
al. Evaluation of S-adenosylmethionine in primary fibromyalgia: A
double-blind crossover study. Am J Med 1987;83(suppl
5A):107-10.
22. Volkmann H, Norregaard J, Jacobsen S, et al.
Double-blind, placebo-controlled cross-over study of intravenous
S-adenosyl-L-methionine in patients with fibromyalgia. Scand J Rheumatol
1997;26:206-11.
23. Jacobsen S, Danneskiold-Samsoe B, Andersen RB.
Oral S-adenosylmethionine in primary fibromyalgia: Double-blind clinical
evaluation. Scand J Rheumatol 1991;20:294-302.
24. Abraham G,
Flechas J. Management of fibromyalgia: Rationale for the use of magnesium
and malic acid. J Nutr Med 1992;3:49-59.
25. Russell J, Michalek J,
Flechas J, et al. Treatment of fibromyalgia syndrome with SuperMalic: A
randomized, double-blind, placebo-controlled, crossover pilot study. J
Rheumatol 1995;22(5):953-7.
26. Citera G, Arias MA, Maldonado-Cocco
JA, et al. The effect of melatonin in patients with fibromyalgia: a pilot
study. Clin Rheumatol 2000;19:9-13.
27. Kaplan KH, Goldberg DL,
Galvin-Naduea M. The impact of a meditation-based stress reduction program
on fibromyalgia. Gen Hosp Psychiatry 1993;15:284-9.
28. Sprott H,
Franke S, Kluge H, Hein G. Pain treatment of fibromyalgia by acupuncture.
Rheumatol Int 1998;18:35-6.
29. Waylonis GW. Long-term follow-up on
patients with fibrositis treated with acupuncture. Ohio State Med J
1977;73:299-302.
30. Deluze C, Bosia L, Zirbs A, et al.
Electroacupuncture in fibromyalgia: results of a controlled trial. BMJ
1992;305(6864):1249-52.
31. Berman BM, Ezzo J, Hadhazy V, Swyers
JP. Is acupuncture effective in the treatment of fibromyalgia? J Fam Pract
1999;48:213-8.
32. Wolfe F. The clinical syndrome of fibrositis. Am
J Med 1986;81(Supp 3A):7-14.
33. Blunt KL, Moez HR, Rajwani MH,
Guerriero RC. The effectiveness of chiropractic management of fibromyalgia
patients: a pilot study. J Manipulative Physiol Ther
1997;20:389-99.
34. Hains G, Hains F. Combined ischemic compression
and spinal manipulation in the treatment of fibromyalgia; a preliminary
estimate of dose and efficacy. J Manipulative Physiol Ther
2000;23:225-30.
Source: NOW Foods
View products
| |
Please Note: This Traditional Use information is provided as a courtesy only. The products indicated above may be listed in error. This information is based on Traditional and Folklore Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA and is not based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
| | 1 product | | | | |  |
|
Fibromyalgia (Fibrositis) - Health - Grapefruit Plus - 355 mg
90 tablets
6.83 US
In Stock - Ships Today!
More Info
| |
| |
| |
| |  |
|
