Fibromyalgia and Chinese Medicine

By Jiang Liu, Diplomate of Oriental Medicine
AR Licensed Acupuncturist and Herbalist
Acupuncture & Chinese Medicine Clinic
2024 Arkansas Valley Dr., Suite 402
Little Rock, AR 72212

 

Fibromyalgia (FM) or fibromyalgia syndrome (FMS) is chronic, widespread musculoskeletal pain and stiffness, as well as fatigue, poor sleep and the presence of localized tender points. This syndrome affects roughly four to six million Americans, 75% of whom are women between the ages of approximately 35 to 55.

Symptoms
Fibromyalgia can vary, depending on weather; stress; physical activity; or just the time of day. Common signs and symptoms include:

  • Widespread pain
  • Fatigue
  • Sleep disturbances
  • Irritable bowel syndrome (IBS)
  • Chronic headaches and facial pain
  • Heightened sensitivity
  • Numbness or tingling sensations in the hands and feet
  • Difficulty concentrating and mood changes
  • Chest or pelvic pain
  • Irritable bladder
  • Dry eyes and mouth
  • Sensation of swollen hands and feet

Possible causes
The causes of fibromyalgia are unknown. Some hypothetic causes are: genetic predisposition, stress, central dopamine dysfunction, abnormal serotonin metabolism, deficient human growth hormone secretion, psychological factors, or an aberrant immune response.

Conventional treatment
As with many other medically unexplained syndromes, there is no known cure or universally accepted treatment for fibromyalgia. The treatment is typically aimed at symptom management, improving the quality of sleep and reducing pain, anti-depression. While some patients respond well to these drugs, improvement varies from person to person. In addition, most medications have side effects.

  • Cognitive behavioral therapy and related psychological/behavioral therapies could help to reduce the symptoms along with exercise when the cause of fibromyalgia is psychological.
  • Pharmaceutical: Some medications have reduced symptoms in some patients. But side effects make the patient dull, lethargic, potential nephro-toxicity or weight gain, which limits their use.
    • Antidepressants
    • Anti-seizure medication
    • Dopamine agonists
    • Non-steroidal anti-inflammatory drugs (NSAIDs)
    • Narcotic pain relievers or cortisone derivatives

Chinese Medicine
Acupuncture or Chinese Medicine has been gaining popularity as an alternative treatment for fibromyalgia, thanks to its effectiveness and less or no side effects. Approximately 20 percent of people who suffer from fibromyalgia undergo acupuncture therapy within two years of diagnosis.

Basic and clinical research Studies show that µ-opioid receptor (MOR) which is related to pain and mood, is decreased in fibromyalgia patients, while several studies have shown that acupuncture increases MOR binding sites or MOR binding potential in multiple pain and sensory processing regions of brain, helping alleviate pain and improving mood. Acupuncture raises your pain threshold — which is low in people with fibromyalgia therefore gives you long-term pain relief. Acupuncture can deactivate part of your brain’s pain matrix. Acupuncture increases microcirculation and reduces inflammation in fibromyalgia condition. Multiple clinical trials show that acupuncture is more effective for relieving pain, improving depression, reducing the morning stiffness, improving global ratings in the patients with fibromyalgia. World Health Organization (WHO) recognize the efficacy of acupuncture treating sleep disorder, stress, anxiety, depression and general fatigue, which are strongly connected to the underlying complex of fibromyalgia syndrome.

The reasons for fails in clinic trials Some clinical trials did not see the significant benefits from acupuncture. The reasons could be: First, Chinese medicine is a personalized or individualized medicine. No one patient has exact same cause, same symptom, same tongue appearance, same pulse, or same diagnosis. Some times even thought they have same symptom, the cause may be different. Also each individual has one’s own constitution or own lifestyle. The treatment is different from person to person. As a qualified practitioner, you have to choose different acupoints accordingly. However, in most clinical trials, the acupoints are standardized and every patient receives exact same points. Second, fibromyalgia is very complex disorder: chronic, widespread musculoskeletal pain and stiffness, fatigue and poor sleep. Acupuncture alone might not reach maximal benefit and it must combine some other Chinese medicine modalities, especially herbal medicine. However, in clinical trial, acupuncture is only modality the patients get. Third, after acupuncture treatment, the patient’s situation has been changed, as Chinese medicine doctor, you have to evaluate the patients each time when patients visit you and adjust your treatment plan accordingly, while in clinical trial, the patients are stick to one regimen for whole period of trial and acupoints are not adjusted accordingly.

Benefits from acupuncture and herbal medicine

  • Less pain
  • Less morning stiffness
  • Less fatigue
  • Less stress or anxiety
  • Better sleep
  • More relaxation
  • Possible immune system boost
  • Better overall health

Side effects: Acupuncture can be much safer than other therapies, especially if you’re combining several different treatments.

  • No negative interactions with other treatments, including drugs
  • Extremely mild side effects
  • Low risk

Mechanisms and treatment
Chinese medicine views fibromyalgia as a stagnation of qi and blood, deficiency of qi and blood, or imbalance of yin-yang, leading to dysfunction of the varied organs of the body. It often affects liver, spleen, heart, kidney, or multiple organs. The immediate cause is environmental such as Wind, Cold, and Dampness, which penetrate the body’s defenses and lodge in the muscles, tendons and joints, creating obstruction and causing pain, stiffness and other symptoms. The disharmonies of several internal organs in the qi and the blood can predispose a person to fibromyalgia symptoms.

  • People under stress often suffer from obstructed flow of qi and blood in the body because stress affects the liver, which is responsible for the smooth flow of qi. Obstruction creates an environment in which pathogens can invade and lodge.
  • Insufficient blood and qi can make the body’s energetic pathways incompletely filled, allowing pathogens to invade.
  • Genetic predisposition, poor diet, overwork, or insufficient exercise can weaken the internal organs, such as the kidney or spleen – responsible for supplying the kinds of qi that maintain overall resistance – allowing pathogenic Influences to invade as well.

There are four common patterns for fibromyalgia. However, one person may present more than one pattern.
1. Liver qi stagnation – anxiety, anger, irritability, headaches, muscle stiffness in neck and shoulders, insomnia, waking frequently, having difficulty falling back to sleep, or irritable bowel syndrome. All symptoms may be triggered by emotional stress.

  • Treatment principle: smooth liver, move qi and blood.
  • Treatment plan: acupuncture is combined with Chinese herbals, as well as TuiNa or Gwasha or cupping according to individual condition.

2. qi and blood deficiency – specifically spleen qi deficiency and heart blood/liver blood deficiency, with such symptoms as chronic fatigue, exhaustion, dull headache, muscle weakness and numbness, insomnia, dream-disturbed sleep and waking up with tiredness, palpitations and depression.

  • Treatment principle: tonify qi and blood, calm the spirit
  • Treatment plan: acupuncture is combined with Chinese herbals, as well as moxibustion, TuiNa, gwasha or cupping according to individual condition.

3. qi stagnation and blood stasis – aches and pains in the whole body, burning or gnawing pain with tingling sensations in extremities, headaches.

  • Treatment principle: move the qi and blood, alleviate pain
  • Treatment plan: acupuncture is combined with Chinese herbals, as well as moxibustion, TuiNa, gwasha or cupping according to individual condition.

4. Kidney deficiency (either yin, yang, qi or essence deficiency) – there will be impotence or lack of libido for males and infertility issues for both males and females. Other symptoms: sore lower back with restless leg syndrome, irritable bladder, dysmenorrhea, amenorrhea, premenstrual syndrome, hot flashes and night sweats.

  • Treatment principle: tonify qi, tonify essence and yang, and nourish yin
  • Treatment plan: acupuncture is combined with Chinese herbals, as well as moxibustion, TuiNa, gwasha or cupping according to individual condition.