Complementary and Alternative Therapies

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Many persons with FM turn to providers of complementary and alternative medicine (CAM). CAM providers are consistently ranked highly by FM patients. Unfortunately, the studies on the efficacy of CAM therapies in FM are somewhat inconsistent. Nonetheless, many patients experience relief from alternative medicines, and CAM treatments can be considered additionally helpful in restoring hope and confidence for the future; this outcome should not be minimized. The fine line to be negotiated when selecting CAM therapies is protection for finances when recommended therapies include benign but costly ineffective or untested treatments. Alternately, persons who have tried CAM therapies with no relief may feel guilty for not improving. A stellar CAM provider, like a stellar allopathic (standard Western medicine) provider, will reassure patients that if therapies are not effective it is not the patient's fault. Continuing to use and promote an unproven therapy that shows no ongoing health advantage to the patient is always unacceptable in any practice of medicine. Well-tested CAM therapies for FM include acupuncture, chiropractic, electrical therapies, and various vitamins, herbs, and nutraceuticals. Although their mechanisms of action have yet to be fully elucidated, they may be due in some part to stress reduction and their ability to elicit the relaxation response. Patients also might learn to elicit the relaxation response without involving a CAM provider if these therapies prove helpful. Self-help techniques include deep breathing, meditation, central focus (single focus on a word like a mantra or object), and progressive muscle tensing and relaxing.

Acupuncture (a technique of inserting and manipulating fine needles into specific points on the body to relieve pain) was demonstrated to be beneficial in initial open-label studies, meaning that there was no control group. Later, randomized, placebo-controlled studies failed to demonstrate a significant symptomatic improvement but did show objective improvement findings with neuroimaging (body-scanning technology). Some CAM providers have argued that "sham acupuncture points" cannot be a true placebo. Others state that traditional Chinese medicine is not easily studied using allopathic standards, since treatments are not standardized but are individualized to the patient and acupuncture is usually combined with herbal therapies. Acupuncture will continue to be tested in FM, particularly in its connection to the correction of autonomic dysfunction (malfunctioning of the nervous system). One study did demonstrate significant improvements by using electro-acupuncture. It is thought electro-acupuncture may work by releasing tight fibrous bands and muscular contraction knots, similar to the way dry needling (injecting a solid needle into a pain site) or tender-point injections (numbing agents injected into a pain site) are thought to work.

Chiropractors are very useful in FM as they often make the initial diagnosis. This may be due to patients seeking chiropractic manipulation after whiplash-type injuries. Some chiropractors report their adjustments in FM patients do not "hold" like in non-FM patients, and, to date, there is no evidence to support chiropractic adjustments are helpful in the treatment of FM. However, the role of chiropractors may take place early on by diverting regional pain so that it does not become widespread pain, and thus avoiding a leap to central sensitization, the precursor of FM.

Electrical therapies and magnet therapies are frequently used by people with FM, with highly varying levels of success. While there is no evidence reporting magnet therapy to be helpful in FM, electrical therapies have displayed a role in pain relief. Prior to understanding the chemistry of synaptic exchange (specialized junctions through which neurons signal to each other), electrical therapies were common. Nowadays, medications are more commonly used to alter synaptic exchanges, and electrical therapies have fallen into disuse. The FDA has approved certain electrical devices for the treatment of recalcitrant depression. None have been approved for the treatment of FM. Painless stimulation through the scalp or earlobes are the most common therapies. Further study is needed to know if these will be helpful for people with FM. An older, better studied electrical therapy is the Transcutaneous Electrical Nerve Stimulation (TENS) unit, most commonly used for chronic back pain.

Overall, many therapies both pharmacologic and nonpharmacologic play an important role in the treatment of FM. Since coping with chronic illness is a lifelong journey, persons with this disorder can and should take advantage of the many options available for symptom relief and quality of life enhancement. Scientists continue working hard to understand the causes of FM, and their future results will make it possible to fine-tune symptom relief within a multitude of treatment options.

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Acupuncture For Cynics

Acupuncture For Cynics

Have You Always Been Curious About Acupuncture, But Were Never Quite Sure Where To Stick The Needles? If you associate acupuncture with needles, pain and weird alternative medicine then you are horribly misinformed about the benefits of the world's oldest form of medicinal treatment.

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