Have you ever tried-or considered trying – Eastern therapies to treat your fibromyalgia symptoms?
If so, you’re not alone. The National Center for Complementary and Alternative Medicine (NCCAM) estimates that about 90 percent of people with fibromyalgia use some form of complementary and alternative medicine (CAM).
Despite patients’ willingness to try alternative approaches to treat fatigue, pain, and other symptoms of FM, verifying and determining the effectiveness and long-term benefits of each chosen therapy is still difficult. Some therapies, such as acupuncture, have been scientifically studied in relation to FM treatment, with varying and sometimes contradictory results. Other therapies have not been studied as they pertain to FM.
Still, when conventional treatments don’t yield satisfying results, it’s natural for patients to cast their eyes and efforts elsewhere, especially toward the East. Here is an overview of four alternative therapies and their potential impact on FM.
About 90 percent of people with fibromyalgia use some form of complimentary and alternative medicine
“Legend has it that traditional Chinese acupuncture is about 2000 years old,” says licensed acupuncturist Tamara ZumMallen. “It’s based on the premise that your body has lines of energy, called ‘meridians.’ The energy is called ‘chi.’ When chi is stuck in the meridians, you get disease.”
Acupuncturists stimulate certain anatomical points by penetrating the skin with hair-thin needles made of stainless steel or gold and manipulating them by hand (traditional Chinese acupuncture), or by electrical stimulation (electroacupuncture).
ZumMallen says that she has successfully treated people for everything from hay fever to chronic pain and insomnia. FM patients have also turned to acupuncture for pain relief, insomnia, and other symptoms, but scientific studies conducted on FM patients have had varying results.
In one 12-week, randomized study reported on in 2005, directed acupuncture “was no more effective than sham acupuncture at relieving pain in fibromyalgia.” (Annals of Internal Medicine 2005; 143:10-19). Another study, reported in June, 2006, in the Mayo Clinic Proceedings, showed “acupuncture is an effective treatment of fibromyalgia, especially for symptoms of fatigue and anxiety.”
One of the difficulties in yielding definitive data from past research is that the pool of patients in each study has been small; the 2005 study cohort consisted of 100 adults, and the 2006 study cohort consisted of 50 adults. A more recent study, reported on in the Scandinavian Journal of Rehabilitation Medicine (2008 July; 40(7):582-8) only included 58 women.
Also, because the studies’ time frames were finite, it is difficult to say if the positive benefits of acupuncture were long-lasting. Given the relatively thin body of research about acupuncture’s effectiveness, whether or not a patient tries acupuncture is due in large part to the patient’s receptiveness to the therapy.
David Hallegua, MD, a rheumatologist who treats FM patients, says, “Some people can’t stand the idea of inserting needles into muscles that are already painful. Acupuncture may be helpful for specific problems, such as a localized musculoskeletal condition like a trigger point or low back pain. But whether it can treat generalized pain is more doubtful.”
Most states require acupuncturists to be licensed. Your treating physician is the first person to ask for a referral to an acupuncturist who understands and has treated fibromyalgia. Other FM patients are also good sources of referrals.
The American Association of Acupuncture and Oriental Medicine (AAAOM) has a list of which states require licensing, as well as a directory of practicing acupuncturists. The American Academy of Medical Acupuncture (www.medicalacupuncture.org) has a list of MDs and_osteopaths who also practice acupuncture.
Some insurance companies will cover medically necessary acupuncture. Before committing to a course of treatment, be sure to check with your insurance company to see if acupuncture is covered under your plan.
“I used to get massages every week for free-my best friend is a certified massage therapist,” says Caroline. “They always helped. I have noticed that since the massages have not been regular, my pain has gotten worse.” Few scientific studies indicate massage therapy is beneficial for fibromyalgia patients.
In one rare study, published in 2002 (Journal of Clinical Rheumatology 2002;8(2):72-76), for a small group of fibromyalgia patients, massage therapy was found to be more beneficial than relaxation therapy for sleep and pain ratings.
There are many different types of massage therapy. For example, some focus on the deep layers of muscles or trigger points (deep tissue massage, trigger point massage) and others apply less pressure. Which is right for you depends on your specific pain issues; starting off slowly is always best.
“When I refer a patient with fibromyalgia to massage therapy,” says physical therapist Lori Rubenstein, “I usually recommend that the massage therapist use light to medium pressure. Oftentimes, [people with FM] experience treatment soreness [pain] several hours after the massage. Some … cannot tolerate deep massage and some can.”
“Some patients love massage therapy,” adds Hallegua, “but the benefits are short-lived.”
Often massage is combined with low-impact, gentle exercise, such as Pilates, to encourage muscle movement and flexibility. As with acupuncturists, many states have licensing requirements for massage therapists, and some local governments also regulate the profession. Chiropractors and physical therapists also sometimes perform massage therapy as part of their overall treatment.
The American Massage Therapy Association (www. amtamassage.org) can provide referrals. Insurance coverage for therapeutic massage is often tied in with treatment from a licensed physical therapist; as with acupuncture, check with your insurance carrier about specific coverage you may or may not have.
“Acupressure massage is a specific school of massage,” says Rubenstein. “You stay on a tender point and let it release out as opposed to moving through muscles.” Such deep work is not for everyone, but some patients do experience benefit.
“I was getting myofacial deep tissue massage, similar to acupressure,” says Annie. “It really did help, but I had to stop because I could not afford the $40 treatments.”
There are no studies specific on acupressure and fibromyalgia, and because of patients’ sensitivity to pressure applied to tender points, it is probably not among the first choices of patients who wish to explore alternative therapies.
The practice of meditation is thousands of years old. Rooted in the desire to seek inward insight and understanding of the spiritual and sacred, the oldest form of meditation is prayer. Today, many patients rely on quiet, centering meditation to relieve stress, calm anxiety, and relax tensed muscles.
Scientific research on meditation and its impact on health is ongoing, and results thus far have been mixed. Some studies have shown that meditation can be beneficial to people suffering from conditions such as arthritis, anxiety, chronic pain, and depression. The NCCAM is focusing some research attention on more specific studies, and in the coming months and years, there should be more data available on whether meditation has a significant, positive impact on health.
Meditation is inexpensive, can be practiced anywhere, and requires no particular physical talent. It also does not need to be practiced with the direction or participation of anyone but the patient, although some patients do combine meditation with yoga, tai chi, and/or other Eastern mind-body disciplines.
One of the ways to get started with meditation is to find a quiet place, sit comfortably, and breathe deeply and slowly, focusing on the action of inhaling and exhaling. As you breathe in, imagine clean, fresh air entering your body, and as you exhale, imagine your stress, tension, and anxiety being carried out of your body. After a few minutes of this quiet inner cleansing, go on with the rest of your day, resolved to carry your newly nurtured relaxation with you wherever you go.
Ideally, a meditation practice allows patients to find inner peace, resolve, and strength that will help sustain them through the challenges of living with chronic pain and illness. For many patients, this nurturing work is rewarding on many levels, especially in the face of an ongoing condition such as fibromyalgia.
CAM: IS IT FOR YOU?
If you are interested in pursuing a CAM therapy, discuss it thoroughlywith your doctor before beginning. Talk with other FM patients who have tried the therapy you are considering. Find reputable practitioners through referrals from your doctor and/or licensing and professional organizations, and verify insurance coverage before you begin treatment.
Discuss your specific symptoms and expectations with the CAM provider. Carefully track your progress, and call your doctor immediately if you experience any negative effects.
As research continues into the health benefits of CAM therapies, FM patients can stay informed through websites such as nccih.nih.gov and www.fmaware.org for the latest on Eastern treatments and learn more about whether individual therapies might help calm some of the most painful symptoms of fibromyalgia.