Fibromyalgia is mainly described as a chronic fatigue immune dysfunction syndrome, when organism is affected by neurotropic virus, or infection. Additionally it may refer to chronic fatigue syndrome, oist-viral fatigue syndrome and systemic exertion intolerance disease.
Fibromyalgia is also often viewed as a form of lesions of extra-articular soft tissue, characterized by a symmetrical diffuse musculoskeletal pain and the presence of specific hypersensitive points, determined by palpation. Patients suffering from this complex disorder experience depression, have poor sleep, may also complain about irritable bowel syndrome, chronic fatigue syndrome, spasticity, stiffness, restless leg syndrome. Increased sensitivity to pain, including cold and stuffiness is observed.
Etiology and pathogenesis
Patients with fibromyalgia are affected with various intracellular infections such as chlamydia and mycoplasma, and these infections occur with different neuralgias and neuropathies. Chlamydia can recur constantly and cause reactions of delayed and immediate hypersensitivity in chronic fatigue syndrome patients. Observations of immunograms of patients usually states that the reason behind fibromyalgia are one or several neurotropic viruses.
One of the important mechanisms of chronic pain formation in fibromyalgia is the phenomenon of central sensitization – mechanisms of chronic pain, characterized by the fact that after the cessation of series of exposures of painful peripheral incitamenters, a certain level of excitation remains in the central sensory neurons of the dorsal horn and this condition persists for some time autonomously or supported by very low levels of nociceptive stimulation. This leads to the fact that the occurence of weak or non-painful stimulus in the posterior horn of the spinal cord is perceived as pain. Central sensitization changes the characteristics of existing or subthreshold somatogenic pain, distorts and increases the degree of its intensity, duration and spatial extent. However, numerous studies demonstrated that central sensitization can develop in the central nervous system disorders without being peripherally damaged.
It is clearly known that the central sensitization, as well as breach of the descending (noradrenergic and serotonergic) inhibitory control of pain is not due to peripheral changes in the muscles, fascias, ligaments and connective tissue, but as a result of neural disorders in the central nervous system in patients with a genetic predisposition, affected by large amounts of (physical and mental) stress. Possible factors, causing the development of fibromyalgia are: peripheral pain syndromes, infections, physical traumas, psychiatric tension, hormonal disorders (hypothyroidism), medicaments, vaccines. Many psychological factors, such as excess of caution, suspiciousness, disasterization, external locus of pain control, can play an important role in the severity of fibromyalgia symptoms. Special studies have shown that patients with fibromyalgia have decreased serotonergic and noradrenergic activity. It was also found that patients with fibromyalgia were observed with a decrease of serum serotonin and its precursor L-tryptophan, as well as lowering of the main metabolite of serotonin in the cerebrospinal fluid – 5-hydroxyindoleacetate. Neurobiological evidence that fibromyalgia is a condition with increased pain sensitivity, and disorders of perception, is supported by the results of diagnostic techniques: single photon emission computed tomography and functional magnetic resonance imaging.
Clinical picture and diagnosis
The main symptom of fibromyalgia – a chronic, diffuse pain not caused by a pathology of musculoskeletal that bothers the patient for at least three months. The pain is diffuse, spreading throughout the body above and below the waist. Typically, patients describe their condition as “I feel that I have pains everywhere”. Patients usually describe the pain that spreads to all the muscles, but sometimes also report pain and swelling in the joints. In addition, patients often complain of paresthesia, numbness, tingling, burning, pins and needles sensation in the skin, especially in the feet and hands.Behavioural and psychological factors have an impact in the development of the clinical picture of fibromyalgia. The prevalence of psychiatric comorbidity in patients with fibromyalgia can reach from 30% to 60%, and the incidence of mental disorders is even higher. Depression and anxiety disorders – the most common condition. In addition, the majority of patients have cognitive impairment. For example, patients usually describe their problems with concentration or attention as a “haze”.
Fibromyalgia diagnosis standard includes a group of laboratory tests, which reflect the work of the immune system, autoimmunity activity, the presence of infection, provoking fibromyalgia, muscle condition. When diagnosing fibromyalgia it is important to find the cause and provoking infections, and exclude big rheumatic diseases, blood diseases, hereditary pathology, multiple sclerosis, amyotrophic lateral sclerosis.
As stated, being immune dysfunction, disease requires immunogram to be proceeded, the more detailed, the more precise diagnosis can be put. Laboratory tests for fibromyalgia makes sense to take on the subject of the three major issues:
- The presence of infection, provoking an autoimmune activity.
- Cause and nuances of immune system disorders
- The presence of “large” autoimmune diseases such as systemic lupus erythematosus or ankylosing spondylitis.
Standard set of tests for fibromyalgia includes:
- Lyme disease, neuroborreliosis
- Herpes type 1 and 2, herpes type 6, Epstein-Barr virus, Cytomegalovirus, Varicella-zoster virus
- Viral hepatitis B, C, G.
- Chlamydia and Mycoplasma.
- Bacteriological sowings
- Immunogram and autoimmune markers
- The indicator of the current breakdown of muscle tissue
Ultrasound for visualizing enthesitis is prescripted to evaluate inflammation. The source of pain in fibromyalgia is enthesis , attacked by inadequately working immune system. Therefore, the typical points of fibromyalgia and are located in major enthesis. 2 types of changes are measured:
- Indicators of activity of points of fibromyalgia at the time of the study. Those are indicators of current of inflammation, namely edema and exudation of fluid.
- Indicators of recency of inflammation. It is the presence of calcification and ossification in enthesis.
With ultrasound, the presence of indicators of recency of inflammation activity of typical and atypical points of fibromyalgia are estimated, the number of active points and the criteria for setting the diagnosis of fibromyalgia.
Patients with fibromyalgia on physical examination are revealed with a high sensitivity or tenderness at specific points in the body. The study of painful points requires experience. The doctor needs to know exactly where to palpate, and with what force. According to the criteria defined by American College of Rheumatology there are 18 tender points in fibromyalgia:
- Mid-forehead point
- Second rib point
- Low cervical point
- Lateral epicondyle point
- Occiput point
- Trapezius points
- Supraspinatus point
- Left thumbnail point
- Gluteal point
- Greater trochanter point
- Knee point
- Greater trochanter point.
The pressure produced at these points should be 4 kg / cm. While palpating 18 tender points, provide even pressure on the points and with the same effort palpate the other areas of the body for the comparison of sensitivity. Painful points represent areas of increased sensitivity to painful stimuli, and are not the result of local inflammation or tissue damage.
Other researches may be conducted, such as electromyography, main objectives of which are:
- Exclude autoimmune poliomiosite, myopathy, amyotrophic lateral sclerosis;
- The differential diagnosis of fibromyalgia and radicular pain due to compression of the nerve roots and spinal cord;
- Diagnosis of carpal tunnel syndrome (pinched nerves of arms and legs with thickened enthesis).
Medical treatment of fibromyalgia
The first and basically only thing that is appointed in the medical treatment of the disease – are painkillers and antidepressants. To point out, this kind of treatment basically focuses on bringing pain relief, meaning it “struggles” symptoms, not the disease, which is most likely an immunodeficiency caused by viruses or infections.
To neutralize the pain symptoms nonsteroidal anti-inflammatory agents are appointed, mostly topical, since the inner NSAID may have a negative effect on the digestive tract of the patient. Clinically proven effect gives TCAs – tricyclic antidepressants, which are more efficacious than drugs of SSRI – selective serotonin reuptake inhibitors. Fibromyalgia treatment involves muscle relaxants, because the main symptoms relates to pain in the muscle tissue. They crop reflexive muscle tension, improving local blood circulation and relieving pain symptoms.
Naturopathic and effective treatment of fibromyalgia
Every aspect of treatment of fibromyalgia have to be focused on breaking the cause of this disease. Which is most likely immunodeficiency caused by infection or virus. There are several reasons for decreasing of the immune system, and some naturopaths may concern that organism turns off its immune barrier, so the virus, bacteria or infections could consume waste and toxins, from the intercellular fluid. Intercellular fluid is being carried out from the intercellular space by lymphatic system.
To start with – the lymphatic system is complicated network of fluid-filled nodes, vessels, glands and organs, which touches every part of the body. The lymphatic system is closely linked to cardiovascular and complements it. The lymphatic system transports the interstitial fluid from interstitial space through the subclavian vein proteins in the blood. The liquid circulating in the lymph vessels called lymph. The system also carries fat from the small intestine into the blood, which plays an important role in the body’s defense system against infections.The structure of the lymphatic system comprises:
- Lymphatic capillaries, vessels and trunks: a tube through which fluid flows;
- Lymph nodes are: formations, located throughout the body;
- Lymphatic organs: spleen, thymus (thymus) and tonsils;
- Lymphatic ducts: there are two flows – right lymphatic duct and the thoracic duct, which flow into the right and left subclavian veins respectively;
- Lymph: fluid that circulates through vessels.
Lymphatic capillaries are closed at one end tubes, forming a huge network in the tissues and organs of the human body. Capillary walls are very thin, so fluid, proteins and large particles fall freely inside. Since these proteins and particles can not pass through the blood vessel wall, they enter the blood through the lymphatic system. Lymphatic vessels are formed through the merger of tiny lymph capillaries. According to the structure veins resemble lymphatic vessels, but have thinner walls and more valves for preventing the outflow of lymph. All lymphatics pass through lymph nodes. They are grouped into several groups and are arranged along the vessels. Multiple-bearing vessels carry lymph node, and from there it flows only in one or two vessels enduring. In the lymph nodes the lymph is filtered, foreign inclusions are separated and destroyed, and here are produced lymphocytes to fight infection. Efferent vessels departing from the nodes connected to the lymph trunks. In this way, the lymph is transferred from the interstices spaces back into the blood. Any failure or blockage of the lymphatic system leads to tumor tissue, or swelling.
The functions of the lymphatic system:
- The lymphatic system carries away the tissue fluid from the intercellular space.
- It carries the fluid to proteins and subclavian veins and the blood return.
- Transfers fat from the small intestine into the blood.
- Develops cells that protect the body from infection and disease.
- The lymph nodes remove and filter foreign substances and waste products.
Practically, clearing lymphatic system, means waste consumed and recycled by virus or infection is freely moved out of body. This waste and clog is the reason for fibromyalgia. Classical ways to clear lymph, as well as to cure fibromyalgia, bringing life and mental stance in order, are:
Drink More Water
Lymph is 95% water, and if you drink enough water every day, the lymphatic fluid is flowing properly. And one of the most common causes of stagnation of lymph – dehydration. Water and only water can effectively moisten body. And if you want to speed up the process – add lemon juice to the water. Lemon – alkaline fruit, it helps the body mineralization.
The rate at which the lymph flows through the lymphatic system, depends on many factors such as the contraction and relaxation of muscles. Unlike blood, lymph does not have a pump. Therefore, physical exercise significantly accelerate the flow of lymph. Doing exercise one can improve the condition of tissues in stasis and swelling in the joints and muscles. The volume of the lymph through the capillaries and vessels depends on the pressure inside and outside the vessel. Exercise is the best way to keep your lymph system flowing. Any type of exercise will do the trick. While your muscles are moving, they massage your lymphatic system which improves lymph flow. Jumping for 10-30 minutes to help the lymph move passively, stimulating the blood circulation throughout the body. This children’s activity is incredibly efficient in order to make the lymph move more actively. And a good bonus would be improvement of muscle tone – there are studies showing that jumping on a trampoline is not only helping the lymph but also blood flow, and muscle. Walking and running are very efficient and easy to practice. Swimming and biking are also good options, making an aerobic exercise to use your large muscles for a set period of time.
Start Doing Yoga
Yoga is generally a great activity that promotes detoxification. And especially in this help inversions, stand on your head, torso twists, various twisting and so on. Work of the muscles from tension to relaxation also contributes to the free lymph current. All of it releases from stagnation and accumulation of toxins in the lymph. In addition yoga’s ability to free the nervous system from the stress response and put into the relaxation is vital to people whose central nervous systems are sensitive and naturally hyped, and becomes extremely important in the period, while lymph detoxification takes place. The muscles shorten, and get stuck in the shortened position, eventually they hurt. Yoga returns muscles to their normal length, relieving from pain. Exercises that teach to focus thoughts, can help to overcome stress and so-called “fog”, keeping mind in the present, which help to handle pain.Yoga’s breathing practice – Pranayama is control of breath. One can control the rhythms of energy with pranayama and achieve healthy body and mind.Doing breathing exercises helps to improve overall health, including lymphatic system. When breathing in, the pressure in chest decreases and the pressure in abdomen increases, pumping lymphatic fluid upwards from legs and sucking lymph from arms and head to drainage points behind clavicles. Breathing exercises will help to clear lungs and mind. Breathing smooth, without delay. Long breath and a long exhale. Breath helps to squeeze the abdominal cavity harder. There is very much liquid, which must also be sent to the cleaners.
Go to Sauna Once a Week
Once a week go to the bath or sauna. Lymph contains hyaluronic acid, which may be in a gel (thick jelly like) and liquid consistency. On this condition affects the temperature. Getting steamed in bath or sauna, lymph liquefies and begins to run faster. The optimum temperature for lymph – not more than 60C. It is important to remember that the lymphatic system can not get warmed. Upon the lymph nodes can not be used any compression. If a person hurt lymph node under his knee, the joint will swell for a very long time.
Lymphatic drainage massage is a rhythmical technique that works to improve lymph flow throughout body. Research shows that the massage is able to activate up to 78% of stagnant lymph. It mobilizes the lymph detoxification and reduces the load on it.
Start Eating Healthy Food
The main factor for over wasting and polluting of lymphatic system by no means is wrong diet. A healthy diet produces less toxins and waste products, reducing the chance of a clogged lymphatic system. A natural food, uncooked and unrefined, grown in fertile soil and consumed in its fresh state, contains maximum amounts of the chemical elements needed by the human body. Its physical state is such as to permit proper digestion and assimilation. As the food is altered it becomes less complete as a nutritional unit. Separating the food into fractions, as in the process of refining — discarding certain of the fractions and consuming others — means that a number of nutritional qualities will be lost. Heating the food at high temperatures is likewise associated with nutritional losses and changes in physical structure. Other forms of processing and treatment, mixture of the food with various irritants and synthetic ingredients, and then prolonged storage — all these tend to detract from the original value of the food, causing digestive problems, loading drainage – lymphatic system. Right diet should be considered and based on preferences of native bacterial population and microflora. As countless scientific researches states, raw vegetable fiber fits the best. With right supply, microbiota produces all groups of vitamins(A,B,C,E,K), as well as amino acids, biologically important organic compounds containing amine (-NH2) and carboxylic acid (-COOH) functional groups.Of course most of nutrition is obtainable with living food. Raw vegetables, fruits and seeds are most suitable, requiring minimum from organism to process, and leaving no waste and toxins after being digested. This will supply organism with necessary energy for positive thinking and physical active lifestyle.
Start Fasting On a Regular Basis
After several days of fasting, liver transforms broken protein molecules, fats, toxins collected in body, including lymph, into ketonic bodies, which turns into ATP, and leaves the body as an acids.
Fibromyalgia is mainly a chronic immune dysfunction syndrome, when organism is affected by virus, or infection, which on its side is caused by immune barriers turned down. This occurs, due to the reason, that infection and viruses are able to turn clog and pollution, waste and toxins located in cellar and intercellular areas of nerve cells into liquid form, so drainage system of the body – lymphatic system is able to carry it out. Therefore, the cleaner lymphatic system is, the easier lymph completes the task. Thus, main focus should be on providing all necessary conditions, by accelerating and pumping lymph transfer rate through the system. Physical activity meant to control lymph flow with muscles. Consuming water to refresh lymph, and right diet for activating and cleaning digestive system, as well as preventing additional clogging in the lymphatic system. Yoga will help to relieve pain and clean mind, while general cleanse is proceeded.