What is Fibromyalgia Syndrome?

Fibromyalgia is a medically unexplained syndrome characterized by chronic widespread pain, a heightened and painful response to pressure, insomnia, fatigue, and depression. While not all affected persons experience all associated symptoms, the following symptoms commonly occur together:

• chronic pain
• debilitating fatigue
• difficulty sleeping
• anxiety and depression
• joint stiffness
• chronic headaches and jaw pain
• difficulty swallowing
• dryness in mouth, nose, and eyes
• hypersensitivity to odors, bright lights, and loud noises
• inability to concentrate (called “fibro fog”)
• incontinence
• irritable bowel syndrome
• numbness or tingling in the fingers and feet
• painful menstrual cramps
• poor circulation in hands and feet (called Raynaud’s phenomenon)
• restless legs syndrome

Fibromyalgia is diagnosed when there is a history of widespread pain in all four quadrants of the body for a minimum duration of three months and pain when pressure is applied to at least 11 of 18 designated tender points on the body, This condition does not result in any physical damage to the body or its tissues and there are no laboratory tests which can confirm this diagnosis.

Symptoms often begin after a physical or emotional trauma, but in many cases there appears to be no triggering event. Women account for a disproportionate number of FMS cases although some researchers believe this is due to the willingness of women to seek treatment.  The risk of fibromyalgia increases with age.

Oriental Medicine does not recognize fibromyalgia as one particular disease pattern. Instead, it aims to treat the specific symptoms that are unique to each individual depending on their constitution, emotional state, intensity and location of their pain, digestive health, sleeping patterns and an array of other signs and symptoms. Therefore, if 10 people are treated with Oriental medicine for fibromyalgia, each of these 10 people will receive a unique, customized treatment with different acupuncture points, different herbs and different lifestyle and dietary recommendations.

Because the symptoms of fibromyalgia are highly variable form one person to another, a wide array of traditional and alternative treatments has been shown to be the most effective way of treating this difficult     syndrome.  A treatment program may include a combination of psychological or behavioral therapies, medications, exercise, acupuncture, herbal medicine and bodywork.

Research

A recent study from the Mayo Clinic found acupuncture helpful in treating the fatigue and anxiety commonly experienced by fibromyalgia patients. In the trial, patients who received acupuncture to counter their fibromyalgia symptoms reported improvement in fatigue and anxiety, among other symptoms. Acupuncture was well tolerated, with minimal side effects.

In the double-blind study, Mayo Clinic doctors gave 25 fibromyalgia patients acupuncture, and 25 “sham” acupuncture treatments. Patients received six treatments during the two- to three-week study. Those who received acupuncture treatments reported less fatigue and anxiety one month following after treatment than did “sham” group.

“The results of the study convince me there is something more than the placebo effect to acupuncture,” says and David Martin. M.D., Ph.D., lead author of the acupuncture article and a Mayo Clinic anesthesiologist. “It affirms a lot of clinical impressions that this complementary medical technique is helpful for patients.”

Dr. Martin performed the study at Mayo Clinic Rochester with co-authors Ines Berger, M.D.; Christopher Sletten, Ph.D.; and Brent Williams. The study used only two acupuncturists and examined only patients who reported more severe symptoms, offering better experimental control. Still, the Mayo Clinic doctors urged more study to see how acupuncture can best be used in treating fibromyalgia patients.

Source: Mayo Clinic (2006, June 13). Acupuncture Relieves Symptoms Of Fibromyalgia, Mayo Clinic Study Finds.

Acupuncture is extremely effective at treating carpal tunnel syndrome; eliminating the need for surgery or the use of anti-inflammatory drugs or corticosteroids.  In fact, one of the most common reasons that people get acupuncture is for repetitive stress injuries, including carpal tunnel syndrome. Recent studies even suggest that acupuncture may be more effective than corticosteroids when it come, to treating CTS.

What is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway in the wrist made up of ligaments and bones. The median nerve and the tendons that connect the fingers to the muscles of the forearm pass through this tightly spaced tunnel. Carpal tunnel syndrome, also known as median nerve entrapment, occurs when swelling or irritation of the nerve or tendons in the carpal tunnel results in pressure on the median nerve. The median nerve controls sensations to the palm side of the thumb and fingers, as well as impulses to some small muscles in the hand that allow the fingers and thumb to move.

Symptoms usually start gradually, with frequent burning, tingling, or numbness in the palm of the hand and the fingers, especially the thumb, index and middle fingers. The symptoms often first appear during the night. As symptoms worsen, people might feel pain, weakness, or numbness in the hand and wrist, radiating up the arm during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. If not properly treated, CTS can cause irreversible nerve damage and permanent deterioration of muscle tissue.

Diagnosis and Treatment of Carpal Tunnel Syndrome with Acupuncture

From an Oriental medicine perspective, CTS is seen as a disruption of the flow of Qi and Blood within the area and associated with Cold, Dampness or Wind penetrating the muscles and sinews of the wrist. Acupuncture points, stretching exercises, herbal remedies and nutritional supplements are chosen to treat accordingly.

As well as reducing the swelling, inflammation and pain in the wrist, acupuncture addresses any headaches. neck pain, shoulder stiffness and sleeping problems that often accompany this condition.

Your treatment may also take into account any underlying conditions that contribute to the development of CTS including obesity, rheumatoid arthritis, thyroid problems, diabetes, hormonal changes of pregnancy and menopause.

New Study on Acupuncture &Carpal Tunnel Syndrome

Acupuncture is as effective as the corticosteroid, prednisone, for the treatment of carpal tunnel syndrome (CTS), according to a new study.

The randomized, controlled study that was published in the May 2009 issue of The Clinical Journal of Pain, investigated the efficacy of Acupuncture compared with steroid treatment in patients with mild-to-moderate carpal tunnel syndrome as measured by both nerve conduction studies and symptom assessment surveys.

Seventy-seven patients were randomly divided into 2 groups. One group received eight acupuncture treatments over four weeks, and the other group received oral doses of prednisone, daily, for four weeks. The results showed that acupuncture was just as effective as the corticosteroid for pain, numbness, tingling and weakness. For the symptoms of night time awakening and motor function, the acupuncture group had better results.

The researchers concluded that acupuncture is a safe and effective treatment option for CTS for those who experience side effects to oral steroids or for those who do not opt for early surgery.

In a German study published in the Archives of Internal Medicine, 1,162 adults with chronic, lower back pain were divided into groups treated with the standard pharmaceutical and exercise therapy commonly used in Western medicine and acupuncture. The researchers reported that acupuncture provided relief and lasting benefit to nearly twice as many lower back pain patients as drugs and exercise. Forty-eight percent of the acupuncture patients reported at least a one-third decrease in pain along with improvement in their ability to function, versus 27 percent of the patients treated with conventional methods reporting such benefits.

In the July 2009 issue of Acupuncture Today, they reported findings from a new study.  Published in the May 2009 issue of Archives of Internal Medicine this new study adds to the growing body of evidence showing the efficacy of acupuncture for back pain.

In this study, 638 patients suffering from back pain were divided into four groups:

Individualized acupuncture: This treatment was prescribed by the diagnostician at the beginning of each visit. There were no constraints on number of needles, depth of insertion or needle manipulation. Needles were retained for 18 minutes. Seventy-four distinct points were used.

Standardized acupuncture: This protocol used a standardized acupuncture prescription considered effective for chronic low back pain, including DU3, UB23 on either side, low back Ashi point, UB 40 on either side and KD 3 on either side. All points were needled for 20 minutes, with needle stimulation at 10 minutes and again just prior to removal.

Simulated acupuncture*: This technique used a toothpick in a needle guide tube. All acupuncture points were stimulated with toothpicks at 10 minutes and again at 20 minutes, just before they were “removed.” The acupuncturists simulated insertion and removal of needles at the eight acupuncture points used in the standardized treatment.

Usual care: Participants in this group only received the care, if any, they and their physicians chose. This was mainly medications, and primary care, and physical therapy visits. All participants received a self-care book with information on managing flare-ups, exercises and lifestyle modifications.

At 8 weeks all patients showed improvement, however, the “usual care” group improved only 2.1 points improvement, scored on a disability questionnaire, as opposed to the individualized, standardized and simulated acupuncture groups who improved by 4.4, 4.5 and 4.4 points respectively.

The greater improvement for the acupuncture groups continued to 52 weeks, the end of the study.

Researchers concluded that compared to usual care, acupuncture had beneficial and persisting effects on chronic back pain.  They stated the acupuncture treatments resulted in clinically meaningful improvements in function, and really, isn’t that the bottom line when you’re getting treatment for pain?

*Simulated acupuncture.  Ironically, this simulated acupuncture is known by practitioners by another name – acupressure.  Additionally, many of the earliest acupuncture practitioners used needles-like implements to stimulate a point but did not insert the implement into the body, or if they did it was a very shallow pricking insertion.  Full insertion into the body came later, so it’s no surprise to any acupuncturist that “simulated” acupuncture would work as well as acupuncture with needle insertion.

The Oriental Medicine Perspective of Low Back Pain

In spite of the large number of pathological conditions that can give rise to low back pain, up to 85% of the cases are classified by Western physicians as ‘non-specific’. When low back pain is looked at from an Oriental medicine perspective, it is seen as a disruption of the Qi within the area and associated with a specific disharmony and then treated accordingly.

The basis of acupuncture is expressed in this famous Chinese saying: “Bu tong ze tong, tong ze bu tong” which means “free flow: no pain, no free flow: pain.”

In other words, any kind of pain or illness represents an obstruction in the normal flow of Qi or life force. Simply put acupuncture moves Qi restoring free flow.

The disruption of Qi that results in low back pain is usually associated with the following three disharmonies.  When reading these descriptions, please bear in mind the differences between Western anatomical organs and Oriental Medicine’s organ systems.  As distinct from the Western medical concept of internal organs, this concept from Traditional Oriental Medicine is more a way of describing a set of interrelated parts than an anatomical organ. To differentiate between western or eastern concepts of organs the first letter is capitalized, therefore, in the description of weak Kidney Qi we are in no way associating this with disease of the kidney.  If you have questions on this, please drop me an email or send me a text and I will explain further.

Weak Kidney Qi – In Oriental medicine, the lower back is referred to as the “dwelling of the Kidneys. The majority of chronic low back pain conditions are associated with Kidney Qi Deficiency. This type of pain is dull and comes and goes. It is usually aggravated by over tiredness and improves with rest.

Stagnation of Qi and Blood – When the flow of Qi along the meridians that traverse the lumbar region becomes congested, it is referred to as the stagnation of Qi and blood. This presents with a severe stabbing pain that is worse with rest and better with movement, tender to touch and can be accompanied by stiffness and tightness.

Invasion of Cold and Dampness – Cold, damp type pain is worse in the morning and when the weather is cold and damp. This type of pain Improves with movement and the application of heat.  Stiffness and contraction of back muscles that is aggravated by rest indicates cold predominance while swelling, numbness and a heavy sensation are indicative of dampness.

Next time – Studies on Acupuncture and Low Back Pain