Chinese Medicine for Treatment of FibromyalgiaKate Kent, R.TCMP, R.Ac. May 1, 2011
If you’ve never had (or even heard of) fibromyalgia, consider yourself very lucky! Fibromyalgia Syndrome (FMS) is a nasty, pernicious disease that predominantly targets women 20 to 50 years old. It causes a lot of suffering and, until recently, was often ignored and misunderstood by mainstream medicine. The problem for anyone suffering from FMS is that it’s the umbrella under which many patterns (serious in their own right) lie, so it’s easy to miss the whole picture. It is not a rheumatic, inflammatory, progressive, or degenerative disease.
FMS is defined and diagnosed as a chronic condition, which means that it has been present in the body for at least three months. Anywhere from 90 to 100% of FMS sufferers experience generalized body pain, fatigue, and muscular stiffness, with the symptoms worse in the morning and after exercise. Patients often describe the pain as deep, burning, throbbing, shooting, or stabbing, with 11 out of 18 tender spots. As many as 75% of cases also report suffering from chronic fatigue. These symptoms can be accompanied by additional problems such as poor sleep, headaches, numbness or tingling, difficulty thinking or concentrating, dizziness, sensitivity to light or noise, as well as painful menstruation. About 50-70% of FMS sufferers also have irritable bowel syndrome, blurred vision, depression or mood swings, palpitations, cold extremities, and allergies, especially to chemicals. There can also be restless leg syndrome, itchy skin, poor hearing, asthma, bladder irritation, and TMJ pain.
While I have never seen all of the above symptoms present in one person, I have certainly seen several of these symptoms bunched together. In terms of Traditional Chinese Medicine (TCM) disease theory, the signs and symptoms of FMS are primarily due to a dysfunction of the liver and spleen.
The liver overacting on a weak spleen can be a major cause of many FMS symptoms, because the liver is also responsible for the smooth flow of qi around the body. The liver reacts strongly to emotions such as anger, frustration, and resentment, and this reaction impedes the flow of qi. If qi gets blocked, it can overflow into the spleen, upsetting the spleen’s function of making blood and resulting in blood deficiency. The spleen’s job of blood production can also be impaired by poor eating habits (eating on the run, eating deep fried food, eating raw vegetables and salads, or eating while angry, etc.), excessive thinking and stress, prolonged exposure to dampness, and chronic disease. This condition has a direct impact on the severity and prolonged existence of an FMS attack.
Another cause of blood deficiency is the decline in blood production as women age and their child-bearing years end. As natural as this process may be, some people experience moderate to severe problems, while others sail right through it. A weak spleen is going to produce a lot of dampness. Think of it as a sponge soaking up nutrients and squeezing them out into the body. If the spleen is weak, the sponge doesn’t have the energy to “squeeze” and it becomes waterlogged. This dampness can cause a feeling of heaviness, aches and pains, headaches, poor appetite, disrupted bowel function, fatigue, poor memory, fuzzy thinking, and depression.
Spleen dampness, over time, will turn to damp-heat, causing the same problems as regular dampness, but with a feeling of heat and discomfort, often accompanied by skin problems.
A statement of fact in TCM theory says, “If there is free flow, there is no pain. If there is pain, there is no free flow.” The liver stores and releases the blood. The qi and blood move together, and if one is stuck or deficient, it will affect the other, resulting in pain just about anywhere in the body, as witnessed in fibromyalgia.
The first step is to undergo a complete assessment, which includes questioning, examining the tongue and pulse, and going over nutrition. In TCM, we always treat the patterns that present themselves; with fibromyalgia, there may well be three to 10 patterns that present simultaneously, and we treat them in order of predominance. We choose an herbal formula in the same way – a formula for the first set of patterns, which can be modified to treat any remaining patterns. Decoctions may include Xiao Yao San or Xiao Chai Hu Tang if there is a liver/spleen disharmony, or Bana Xia Xie Xin Tang if there is damp-heat.
FMS causes so much discomfort and suffering that I always focus on alleviating sleep deprivation as my first priority for a successful outcome. Lack of sleep not only slows the body’s ability to heal, but can be a cause of further anxiety. Depending on the sleep pattern, one possible formula is Tian Wang Bu Xin Dan, which nourishes the heart and calms the spirit.
Acupuncture works on the same premise as herbs. A prescription of points would be chosen according to the pattern that is presented.
Adequate exercise is necessary, but it is important to listen to one’s body, because too much exercise can cause post-exercise malaise. It’s a bit of trial and error in the beginning, until the body indicates what is appropriate. The amount and kind of exercise may vary according to symptoms. Exercise moves the blood, helps strengthen the spleen, and pushes excess heat out of the body. Relaxation is just as important in order for the body to renew and heal, and both exercise and relaxation help with depression.
And, of course, diet is of utmost importance – a bland diet is required to strengthen the spleen and dry dampness.
It is important to remember that, if you are unlucky enough to experience FMS, there is always hope!