April 2008


By Elliot Wagner, O.M.D., L.Ac., Doctor of Oriental Medicine

You have pain all over your body, not just in the joints, but in the muscles, too. You feel tired all the time, yet often can't sleep. When you do sleep, you wake up feeling stiff and still tired. You have headaches you can't explain. You see your doctor, but he or she can't find anything really wrong. These are common experiences of people with fibromyalgia, described by the National Institutes of Health information booklet as "a common and chronic disorder characterized by widespread muscle pain, fatigue, and multiple tender points.

Fibromyalgia is a disease that was accepted by the AMA in 1987 after years of controversy over whether it was a "real disease." In 1990, the American College of Rheumatology produced its diagnostic criteria for fibromyalgia, which stated that there must be a history of three months of widespread pain, on both sides of the body; above and below the waist, and confirmation of at least eleven of eighteen specific tender point sites that must be painful on digital palpation.

That is all that is theoretically required to make a diagnosis of fibromyalgia, but it touches only the surface of what fibromyalgia patients experience. Fibromyalgia has been compared to many other diseases because it shares many symptoms in common with them. This what makes it so hard to diagnose. It is compared with chronic fatigue syndrome, or CFIDS, because the two share ongoing, often debilitating fatigue, plus insomnia, anxiety and depression, poor resistance to illness, impaired memory and concentration, and many other problems. It is also compared with irritable bowel syndrome because the two share common symptoms of chronic bowel disturbances and weakened immunity.

The cause of fibromyalgia is unknown, however my experience leads me to agree with the theory that it has something to do with adrenal function. When the adrenal glands can no longer effectively cope with stress, they become exhausted. This leads to a dominance of the "fight-flight" response. One becomes much more sensitive to pain and other stimuli, more wakeful and anxious, and less able to sleep, relax, or digest food properly. This response leads to a downward spiral of increasing symptoms and debility.

A study published in 1996 from the prestigious Mayo Clinic looked at whether acupuncture could be a helpful treatment to relieve the pain of fibromyalgia. Among 50 participants, those who received acupuncture reported improvement in pain, fatigue, anxiety, and affective distress, a term most of us would define simply as "stress."

David Martin, M.D., Ph.D., is a Mayo Clinic anesthesiologist and was the study's lead investigator. In the press release from the Mayo Clinic he says: "Our study was performed on patients with moderate to severe fibromyalgia. It's my speculation that if acupuncture works for these patients with recalcitrant fibromyalgia — where previous treatments had not provided satisfactory relief — it would likely work for many of the millions of fibromyalgia patients."

"We expected the acupuncture to improve the pain, we didn't really expect the largest benefit to be in fatigue or anxiety. There's not a cure available, so patients are often left somewhat frustrated by continuing pain and fatigue. Acupuncture is one of the few things shown to be effective for these symptoms. It may be particularly attractive to patients who are unable to take medications because of intolerable side effects."

We have been able to help a number of people with fibromyalgia in our clinic, and we have observed that acupuncture and Chinese herbs based on a thorough Oriental Medicine diagnosis make a difference in how people feel day to day, with less fatigue, less fear, and more pain-free days.