that there are at least 11 of 18 identified spe- cific locations around the body that patients tend to feel tenderness at. This would clinch the formal diagnosis, but in the real world, if a patient has the characteristic type of pain and associated symptoms of fibromyalgia, the clinical diagnosis is made without strict adherence to the number of eleven tender spots to use the diagnosis, as defined in the diagnostic criteria. Now consider what one may find do-
ing research on symptoms associated with fibromyalgia besides their pain: anxiety and depression, chronic headaches, dryness in mouth, nose, and eyes, sensitivity to cold and/or heat, inability to concentrate, irritable bowel syndrome, numbness or tingling in the fingers and feet, poor circulation in hands and feet (Reynaud’s phenomenon), restless leg syndrome, stiffness. There is quite an overlap. So how does one decide whether their condition is Chronic Fatigue syndrome, or Fibromyalgia? For some patients with fatigue there is little pain, but for most with fibromy- algia pain, fatigue is also a large problem. So for many, it would seem that the most appro- priate label would seem to be “Fibromyalgia/ Chronic Fatigue Syndrome.”
Getting past the definitions we are left with patients who have a whole host of problems for which there is no clear cure. There are two medications that have been approved by the FDA for fibromyalgia pain, Cymbalta and Savella. Both have the chemi- cal characteristics of antidepressants. A vari- able effect has been found in patients, and although helpful for some, these are not the real answer to this problem. There is also no clearly known single cause and there cannot be one cure to the variety of problems that are associated, and the symptoms that mani- fest with Chronic Fatigue or Fibromyalgia. No wonder that these patients have a dif- ficult condition to bear, and the doctor has a difficult condition to try and treat. If there is no clear treatment then what can be done?
Fibromyalgia / Chronic Fatigue Syndrome
Where Integrative Medicine is Essential Doctors treating this need to think “out of the box “with regard to natural therapies including dietary approaches that provide so much more than simply using medications for symptom relief. To even attempt to heal the person’s system as a whole, a holistic ap- proach taking into account mind-body con- nection, dietary and lifestyle influences and the like, provide the best hope for sufferers.
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