#114 Alternative Therapies

In This Issue:

~ Reader Feedback
~ 5 alternative medicine treatments that work
~ Can Alternative Therapies Enhance Conventional Medicine?
~ Could "alternative" therapies do more harm than good?
~ Complementary therapies may help your chronic pain: acupuncture, hypnosis, and other alternative treatments may ease pain that doesn't respond to medical therapy, says an MGH expert
~ Fibromyalgia Patients: A Real Pain in the Muscles and Fibers

Reader Feedback

I have fibro and have had it for 5 yrs..What has been working for me of late is cutting all sugars out of my diet and processed foods flour too..Also a increase in supplements 1000mg Vit D3,3600 mg Fish oil, 2600 mg flax seed oil ,calcium mag and zinc mixture 3 times a day ,1000 mg Vit C..I have been doing this for a month now and have noticed a huge improvement. I have more energy and less pain..I still have to take my pain pills but I feel better..This and alot of support from my family and friends helps so much...

Thank you
Melinda in Portland Ore.
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My doctor sent me to physical therapy for an evaluation but because fibromyalgia is so wide spread they put me in the aquatics program. It is easier on your body and it does work. I had to stop because of an operation and as the weeks went by my pain came back little by little. I can't wait to get back to it. It may seem like your not doing much but you are.
Debbie in Ohio
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Works for me:
SAM'e (s-adenosyl-L-methionine - 400 mg 2x daily - better pain relief than anything else I've tried!);
heating pads (stick to low settings, or erythema ab igne - literally "redness from fire" - can discolor your skin)
TheraCane (snorkel-shaped device that lets you reach around your back for self-massage of muscles and trigger-points)
weekly trigger point massage and general deep tissue massage (counterintuitively, the more it hurts during the massage, the better I am afterward);
magenetic insoles;
just saying "NO" to people and activities and resting positions that hurt;
using unavoidable daily chores (work, driving, shopping, housecleaning, etc.) as my exercise/physical therapy rather than trying to introduce new actitivies that my body is not used to.

Has not worked for me - no pain relief:
Homeopathic remedies
Accupuncture (hurt a lot, made me sick to my stomach)
Aura Soma products (colored, scented oils, etc.)
Organic food diet
Raw food diet
Topical salicylate ointments
Anti-inflammatory pain killer pills, including natural supplements (non-clotting nosebleeds result from the blood-thinning effect!)
Rheumatologists
Physiatrists
Physical therapists (major disasater! work-hardening is exactly what I should NOT be doing)
General Practioners
"Eat Right 4 Your Type" (a diet based on blood type)
Low carb diets
Low protein diets
Light Body (meditation/energy-work tapes)
Reiki
Taiji (Tai Chi)
Yoga/Stretching
Chiropractic adjustments
Magnetic mattress and chair pad (made me feel "wired" all the time - like an overdose of caffiene; might be good for those struggling with lethargy, but not good for relaxing one's muscles) RKNSRN
Hi
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I was diagnosed by two different Rheumatologists with Fibromyalgia 12 years ago. I could only work a few days a week, had many flareups and lost hours of work. Today I work 5+ days a week and walk 2 miles a day. My godsend of a doctor (Rheumatologist) put me on Ambien for sleep, Immipramine and Ultram for pain. I still get the Fibromyalgia pain when the borameter drops, but nothing like years ago. Hope this can help someone.
Linda

Shed any excess weight. Use the plan that suits you. Change your eating habits and continue it for life. You will have more energy.

I removed gluten, additives and preservatives from my diet. I eliminated as much white flour from my diet as I could. If I need to make something special. I use half white gluten free flour and half brown rice flour. Cook from scratch using fresh foods. Buy organic where you can afford it. Put ground flax seed on your cereal and in your baking. Eat plenty of fruit and vegs. Limit meat intake to around 100grams per serving. Eat oily fish at least once a week. Fresh if possible.

Reduce sugar consumption.

Made sure I eat an apple a day for the Malic acid content.

Gentle exercise despite the pain. Move it or lose it.

Made tomatos and potatos and all the deadly nightshade family an occasional treat.

No soda's diet or otherwise.

Limit coffee consumption - I have only one cup a day now very early in the morning. I grind beans rather than buy the prepared coffee in a pack.

Keep hydrated - drink lots of water.

Avoid using harsh chemicals and weedkillers in your home. Limit the number of cleaners you use and find natural ones to use. I use white vinegar and water for a lot of chores.

For those who suffer skin problems use hypoallergenic shower gels and elimate soap. Buy soap powders for sensitive skin.

I have a huge reduction in muscle pain, less fatigue, and my irritable bowel symptoms have gone. I have a much better quality of life than I had five years ago when I first began this regime. I believe fibromyalgia symptoms can be relieved. I documented my regime for my doctor and I know of at least one other patient personally who has benefited from my experience. I did lots of research eliminating one symptom at a time and did not treat the disease as one entity. I believe you have to treat each symptom.

I have not had to take pain killers for a long time if I do get sore I use heat and a natural rub called Antiflamme. My sleeping pattern is better since I began my new lifestyle. It is a lifestyle. This is not a cure but a means to live life as best as you can as a fibromyalgia patient.

I was very sad when I tried to share my experience with other patients in an online forum I had belonged to for some years and got thrown out of the forum for daring to suggest there was hope and you can improve your quality of life. Sure it takes effort and discipline but its worth it!

Hope this is of assistance

Carolyn Stirling
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I have found the most relief from massage therapy.
I was in Lyrica test group and took 100mg 3 times a day for about a year after completion of study, but did not like the foggy feeling and certainly was not happy with the weight gain so physician switched to Cymbalta 60 mg which seems to help over-all symptoms and pain. However, for pure enjoyment and relaxation, massage works best for me. Tried acupuncture, but while it brought some relief, did not help that much.
Bill/Pat
I would have to say by far the most effective alternative suppliment i
take is D-Ribose.I simply would not be able to function let alone keep
working without it.I take it in powder form that i buy in bulk
online(Its much cheaper than pills),I take 2-3 tsp a day in water.The
biggest change is my energy level,without it i'd be confined to
bed!But its not just energy it also helps with my stiffness/pain and
fibro fog levels too.Even my husband has tried it for energy and he
does not have fibro.
I also take magnesium and malic acid pills for the stiffness,5-htp and
valerian for sleeping and B-12 for when i need extra energy for
something but its the D-ribose that has been the most obvious help for
me.
Michelle

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I found two somewhat unorthodox treatments to have some positive effect on the FMS that afflicts me.

The first is osteopathic manipulative medicine, both the type developed in the 19th Century by Dr. A.T. Still and cranial osteopathy developed at the Upplanger Institute.

The second was cognitive behavioural therapy, which did nothing for the symptoms themselves, but helped me get over the why me and poor me questions and complaining.

Father Daniel Beegan

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I have had fibromyalgia going on nine years, and for me it seems to be progressive. I have not been able to work for a little over two years; I was a senior health care executive with a six-figure income. What I have found works for me is a good long cry, about 15 minutes or so. I just let it all out, along with some screaming, cursing, and saying whatever it is I need to say, no matter how irrational or ‘crazy’ it may be. Afterwards, I feel much better – it’s cathartic, purifying, and cleansing for me. The emotions are raw, almost primitive, and have to be let out, so I do. I do this alone, while my wife is not at home, because I think it would terrify her if she heard me, and I would not want to subject her to that. She is a wonderfully caring, understanding soul mate who I love deeply and completely. Don’t get me wrong – I take my medications (10) faithfully, get as much exercise as I am able, and hold on to a lot of hope that someday, somehow, this horrible disease will be eradicated. But letting out all of my frustrations, despair, hurt, pain, etc. with a good long cry works for me.
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Patrick
I have found that exercising in a pool of 94 degrees for 40 minutes a day twice a week works wonders. The water alleviates all of your pain while in there and you are able to some good aerobic exercising with ou the pain but all the gain. I have now just started water jogging, you wear a belt so that you literally are running in the water with out touching the bottom, This also provides then some good cardio workouts.
Susie McKee

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What works for me is accupuncture. While I was doing this it really helped with the pain. I got some relief with fatigue, but I think that when your pain levels are more tolerable, you're not so tired. I stoped while waiting to get another appointment with my physical medicine doctor who prescribes the accupuncture for insurance payment. I really felt lousy again waiting in transition.

Anohter thing that works is learning to say NO. It is sometime hard and or impossible, but try it; it really helps.

Stopain Spray gives good tempory relief too. I know it's a name brand, but I did not know how to explain it otherwise.

Diann Earnest Yucaipa, CA
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I have been drinking a juice that contains the freeze dried acai berry, along with a combination of other fruits that are very high in antioxidants and other phytonutrients. This juice has been an absolute life saver for me. While it has not made all my symptoms disappear, what it has done is reduce the pain and fatigue, extend the length of time between flares, and best of all, it seems to have cleared up my fibro-fog almost completely! I have spoken to other people with FMS who also drink the juice, and many of them report some health benefits from the juice. But all of us agree that the juice just plain tastes good. I won’t go back to my morning orange juice even if I didn’t get the health benefits.
Thanks, Lyn
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5 alternative medicine treatments that work By Elizabeth Cohen CNN
Empowered Patient is a regular feature from CNN Medical News correspondent Elizabeth Cohen that helps put you in the driver's seat when it comes to health care.
ATLANTA, Georgia (CNN) -- Dr. Andrew Weil wasn't sure exactly how he hurt his knee; all he knew was that it was painful. But instead of turning to cortisone shots or heavy doses of pain medication, Weil turned to the ancient Chinese medicine practice of acupuncture. "It worked -- my knee felt much better," says Weil.
Americans spend billions of dollars each year on alternative medicine, everything from chiropractic care to hypnosis.
Weil says alternative medicine can work wonders -- acupuncture, certain herbs, guided imagery.
For example, Dr. Brian Berman, director of the Center for Integrative Medicine at the University of Maryland School of Medicine, has done a series of studies showing acupuncture's benefits for osteoarthritis of the knee.
Extensive studies have also been done on mind-body approaches such as guided imagery, and on some herbs, including St. John's wort.
But on the other hand, there also is a lot of quackery out there, Weil says. "I've seen it all, [including] products that claim to increase sexual vigor, cure cancer and allay financial anxiety."
So how do you know what works and what doesn't when it comes to alternative medicine? Just a decade ago, there weren't many well-done, independent studies on herbs, acupuncture, massage or hypnosis, so patients didn't have many facts to guide them.
But in 1999, eight academic medical centers, including Harvard, Duke and Stanford, banded together with the purpose of encouraging research and education on alternative medicine. Eight years later, the Consortium of Academic Health Centers for Integrative Medicine has 38 member universities, and has gathered evidence about what practices have solid science behind them.
Here, from experts at five of those universities, are five alternative medicine practices that are among the most promising because they have solid science behind them.
1. Acupuncture for pain
Hands, down, this was the No. 1 recommendation from our panel of experts. They also recommended acupuncture for other problems, including nausea after surgery and chemotherapy.

2.Calcium, magnesium, and vitamin B6 for PMS
When pre-menstrual syndrome rears its ugly head, gynecologist Dr. Tracy Gaudet encourages her patients to take these dietary supplements. "They can have a huge impact on moodiness, bloating, and on heavy periods," says Gaudet, who's the executive director of Duke Integrative Medicine at Duke University Medical School.

3. St. John's Wort for depression
The studies are a bit mixed on this one, but our panel of experts agreed this herb -- once thought to rid the body of evil spirits - is definitely promising. "It's worth a try for mild to moderate depression," says Weil, founder and director of the Program in Integrative Medicine at the University of Arizona. "Remember it will take six to eight weeks to see an effect." Remember, too, that St. John's wort can interfere with some medicines; the University of Maryland Medical Center has a list.

4. Guided imagery for pain and anxiety
"Go to your happy place" has become a cliché, but our experts say it really works. The technique, of course, is more complicated than that. "In guided imagery we invite you to relax and focus on breathing and transport you mentally to a different place," says Mary Jo Kreitzer, Ph.D., R.N., founder and director of the Center for Spirituality and Healing at the University of Minnesota.
There's a guided imagery demo at the University of Minnesota's Web site.

5. Glucosamine for joint pain
"It's safe, and it looks like it's effective," says Dr. Frederick Hecht, director of research at the Osher Center for Integrative Medicine at the University of California, San Francisco. "It may be the first thing that actually reverses cartilage loss in osteoarthritis."
All our experts warn that since alternative medicine is financially lucrative, a lot of charlatans have gotten into the business. They have these tips for being a savvy shopper:

1. Look for "USP" or "NSF" on the labels
"The biggest mistake people make is they don't get a good product," says Dr. Mary Hardy, medical director of the Sims/Mann-UCLA Center for Integrative Oncology. She says the stamp of approval from the United States Pharmacopoeia or NSF International, two groups with independent verification programs, means what's on the label is in the product.

2. Find a good practitioner
Make sure the alternative medicine practitioner you're going to is actually trained to practice alternative medicine. One place to start is the Consortium for Academic Health Centers for Integrative Medicine

3. Be wary of crazy claims
"Anything that sounds too good to be true probably is," says Weil.
And once you do start on your journey with alternative medicine, here's a piece of advice: Take it slow. Alternative medicine works, but sometimes not as quickly as taking a drug. "I tell people it's going to take a while," says Hardy. "I tell them to do a six- to eight-week trial, or even 12 weeks."

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Can Alternative Therapies Enhance Conventional Medicine?
By Deepak Chopra, M.D.

The great promise of mind-body medicine will never be fulfilled as long as the treatments are unpredictable. This has been a major stumbling block in the West, ever since the original excitement over acupuncture in the '70s and Ayurveda in the '80s. Patients who have been helped sing the praises of alternative medicine while official clinical trials don't satisfy the skeptics.
In the East it is more easily accepted that each patient is unique, and therefore one cannot expect that the same therapy will lead to the same results in
everybody. One sees this in the placebo effect, also. You can give inert sugar pills to cure pain, and the pain will go away in some patients but not others.

To a Western-trained physician, this lack of reliability undermines the treatment's credibility. Medical schools teach their students to expect a shot of penicillin or an appendectomy to lead to a cure as reliably for patient A as for patient B. In practice there is no such thing as complete reliability, however, and one must consider how many patients die on the operating table or suffer extreme side effects from drugs.

There is also the problem that drugs become less effective over time - the phenomenon known as tachyphylaxis - and that "super germs" develop in hospitals, causing a serious rise in illness and death caused by the treatment - a phenomenon known as iatrogenic disease.

In response to the growing resistance of microbes to standard antibiotics, drug companies promise to develop new alternatives as the germs learn to beat the old drugs, but unless there's big money in it, the pharmaceutical research isn't undertaken with any great enthusiasm or speed. Hence the vicious circle of ineffective drugs, smarter germs, and rising drug prices that plagues American medicine.

That's one reason, among many, why mind-body medicine poses a brighter future than the proponents of standard drugs and surgery are willing to concede. (The fact that the average American over 70 takes seven prescription drugs a day must make anyone pause.)
The public already trusts alternative medicine far more than the official voices who warn against it year after year. One reads of the dire effects of vitamin A poisoning, for example, when in reality the number of megavitamin overdoes in this country is minuscule compared to the thousands of people who get sick and die from hospital infections.

It's like condemning nutmeg as a hallucinogen while and ignoring the crash of five jumbo jets. The New England Journal of Medicine has been much less sympathetic to alternative medicine than the leading British journal, The Lancet, which ran a 2005 article on the effectiveness of homeopathy in treating and preventing colds and flu.
Almost immediately The Lancet ran a counter article bolstering the conventional view that homeopathy isn't effective. This represents the usual confusion. Adherents to alternative medicine clash with the establishment, both sides pointing to their own research, but both sides also having to admit that definitive results never seem to settle their disputes.

I've come to feel that the argument will never be settled until we accept a fact of nature: everyone has a unique response to disease. No single treatment can be expected to cure or prevent illness with complete reliability, and even if Western medicine is right to claim that a drug like penicillin works more often than any alternative, Eastern medicine can point to drug intolerance, side effects, and expense as considerable drawbacks. (Not to mention the exponential risks that often mount when pharmaceuticals are mixed with one another, or with alcohol consumption.)

Therefore, each of us needs to consider our own bodies, our own life history, and our own susceptibility. Mainstream medicine constantly tries to sell its one-size-fits-all position, and it shouldn't. For decades all patients with high blood pressure were put on reduced salt diets that they found hard to tolerate, despite the fact that over 80 percent of people are not salt sensitive and can eat as much salt as they want.

Over that same period, low-cholesterol diets were pushed for all patients at risk for premature heart attacks, even though the connection between the cholesterol you eat and the cholesterol in your blood varies widely. To claim that there was a simple correlation was bad science.
Meanwhile, the strong correlation between heart attacks and psychological stress was pursued with much less enthusiasm, if at all. Today, of course, newer and better drugs are meant to solve all problems. What, then, can you and I do to offset the unpredictable nature of healing? The answer doesn't lie in a simplistic choice between drugs and surgery all the time or none of the time. We have to envision a new future for the body, and with that in hand, intelligent choices can be made from both sides of the medical menu, mainstream and alternative.

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Could "alternative" therapies do more harm than good? Experts caution that supplementation could be dangerous

There's no shortage of "alternative" treatment options available today, but some therapies are not only unproven--they're also potentially dangerous. Physicians warn that while the makers of dietary supplements may claim to offer "natural" treatments, any pill you take can act like a drug and therefore carries a risk of adverse events and drug interactions. On top of that, there is no guarantee that these supplements even work.

As we grow older, it's normal for the levels of certain chemicals and hormones--such as testosterone--to decline, but taking a pill to replace what you've lost isn't always the safest solution. "The blood level of a substance declines with age, but returning it to 'youthful' levels doesn't necessary help and may actually cause harm," says Rosanne Leipzig, MD, PhD, professor and vice chairman of geriatrics at Mount Sinai School of Medicine.

For example, postmenopausal women do not produce as much estrogen as they used to and, as a result, they can experience bothersome symptoms such as hot flashes and vaginal dryness. However, while estrogen-replacement therapy can alleviate these symptoms, it also can increase the risk of breast cancer and blood clots.

The dangers of dietary supplements. The same problems surround the use of dietary supplements. There is no proof that using supplements to replace what you've lost is safe and effective. For example, the antioxidant selenium tends to decrease as we age, but recent studies have shown that taking selenium supplements could actually increase the risk of developing type 2 diabetes. In addition, a lot of the claims made about dietary supplements have not been scientifically proven.

"Clearly, further studies have to be done before we can make a decision about whether or not a particular supplement is safe," Dr. Leipzig says. "We really have no way of knowing the effects on people without seeing the results of large, randomized, controlled trials."
Unlike prescription drugs, dietary supplements are not currently monitored to make sure that what is stated on the label is actually what is in each pill. "Because dietary supplements are not FDA-approved, anything can be in the bottle," Dr. Leipzig warns. "So you end up paying good money and you don't really know what you're getting."

There is also the risk of interaction between dietary supplements and other drugs you may be taking. For example, ginkgo biloba, ginseng, and garlic should not be taken with blood-thinners because they increase the risk of bleeding. It's important to consult with your doctor to decide if the potential for benefit outweighs the potential for harm.

Truly "natural" therapy. Although aging is a natural process and many people want to live as long as possible, most people don't want to look or feel older. "There are lots of things you can do instead of taking dietary supplements to help prolong your life and ensure maximum health," advises Dr. Leipzig. "The four most important things are to always wear your seat belt, quit smoking, maintain a healthy weight, and exercise regularly."

Dr. Leipzig acknowledges that some dietary supplements, such as glucosamine and chondroitin for arthritis pain, do show promise, but at this point, it's too early to tell which therapies are both effective and safe. You can find more high quality information about alternative medicine at www.jr2.ox.ac.uk/bandolier/booth/ booths/altmed.html and nccam.nih.gov.
COPYRIGHT 2007 Belvoir Media Group, LLC
COPYRIGHT 2008 Gale, Cengage Learning
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Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies
*Note – This book is a bit pricey for most of us, but most libraries should be able to get a copy for you.
Mario Roxas

Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies
Mitchell Bebel Stargrove, ND, LAc; Jonathan Treasure, MA, MNIMH, RH (AHG); Dwight L. McKee, MD

Use of nutritional and herbal products is a multi-billion dollar industry in the United States. As more people take nutritional supplements and herbal medicines, a growing concern among alternative and conventional practitioners is potential drug/herb and drug/nutrient interactions. Consequently, this book--Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies (HNDI)--comes at an opportune time.

The authors have performed the Herculean task of creating, from a vast collection of references, a detailed guide to potential interactions of the most commonly encountered herbs and nutrients with common prescription and over-the-counter (OTC) drugs.

Published in January 2008, HNDI consists of 70 monographs--30 herbs (from Aloe to Vitex) and 40 nutrients (subcategorized as vitamins, minerals, amino acids, and nutraceuticals and physiologics).

Each monograph starts with a quick, at-a-glance summary table identifying the particular drug/ drug class, a brief mechanism of interaction, and a recommended course of action. The body of the monograph supplies the reader with detailed information outlined by the following subheadings:

* Herb/Nutrient Description: General background about the herb/nutrient (e.g., common species, country of origin, parts used, chemical formula, etc.)
* Herb/Nutrient in Clinical Practice: Historical and contemporary indications for usage, key chemical constituents, and dosage ranges
* Interactions Review: General information regarding interactions with drugs
* Herb-Drug/Nutrient-Drug Interactions: More detailed information about herb/nutrient and specific drugs or drug categories
* Theoretical, Speculative, and Preliminary Interactions Research, Including Overstated Interactions Claims
There is a system of symbols throughout the book to aid the reader in determining the level of clinical significance of the herb- or nutrient-drug interaction, type and clinical significance of the interaction, and strength and quality of the source evidence. Although the symbols are intended to be helpful, they can be somewhat confusing. For instance, the same symbol is used more than once to describe different and, at one point, opposing situations.

The authors have compiled a substantial amount of information into one text. And therein lies the value of this book--pertinent drug interaction data for numerous herbs and nutrients in a single reference.
Elsevier Mosby, St Louis, MO 63146
ISBN-13: 978-0-323-02964-3; Softcover; 932 pages; $88.95
Book Review by Mario Roxas, ND
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Complementary therapies may help your chronic pain: acupuncture, hypnosis, and other alternative treatments may ease pain that doesn't respond to medical therapy, says an MGH expert
May 2008

When traditional medical treatment fails to ease your chronic pain, consider trying a complementary therapy. There are a number of non-medical treatments with established safety records--such as hypnosis, massage, acupuncture, mind-body techniques, and psychological counseling--that have been shown to relieve pain in some patients.

For example, researchers have found that a form of interpersonal therapy called cognitive behavioral therapy (CBT)--which helps people replace
unhealthy beliefs and behaviors with more positive ones--may be associated with significant pain reduction in people with irritable bowel syndrome (IBS) who do not respond to medications and dietary changes. A study reported in the August 2007 issue of Gastroenterology revealed that subjects with IBS showed significant improvements in symptoms of pain and bloating after participating in a program of once-a-week CBT sessions for 10 weeks, or four months of once-a-month CBT combined with a regimen of relaxation and problem-solving exercises at home.

"If standard medical treatment doesn't work, it's a good idea to look elsewhere for help," says Randy L. Gollub, MD, PhD, Associate Director of the Psychiatric Neuroimaging Research Program at Massachusetts General Hospital. "Complementary medicine can sometimes bring relief of pain where traditional medicine cannot. It's always best to check with a doctor before choosing a complementary therapy; as long as your doctor has no objections, it may be worth a try."

UNDERSTANDING PAIN
There are many categories of pain, Dr. Gollub explains, and some of these may not respond to standard treatment.
"Some types of pain are caused by ongoing physiological or mechanical processes that can be identified, such as pain following an injury or arising from a specific disorder," she says. "These types of pain are addressable by medical interventions.
"But other types of pain--such as pain that lingers after physical injury has healed or fibromyalgia (a disorder characterized by chronic widespread pain)--are not yet well understood. Such conditions are associated with pathological processes that often fail to respond to our best treatment efforts. In these cases it makes sense to consider exploring complementary treatments to see if any can help bring relief."

OTHER APPROACHES
Although complementary treatments may not work in all cases and scientific data to support the use of some therapies may not be extensive, the principal therapies have minimal side effects and are safe for most individuals. Among the most promising therapies are:
* Psychological counseling: Seeing a mental health professional for treatment of anxiety disorders and mood disorders such as depression can help reduce levels of perceived pain. It also may help individuals with chronic pain to learn relaxation techniques, stress reduction, and other effective strategies for coping with pain.
* Acupuncture: This ancient Chinese form of medicine can be very effective in relieving pain from conditions such as arthritis, headaches and aches in muscles and connective tissues. Therapy consists of inserting slender needles through the skin, muscles and connective tissues at any of nearly 1,000 points along energy channels (meridians) to remove blockages and achieve energy balance. The procedure, which itself is essentially pain-free, is thought to cause the release of natural painkillers called endorphins.
* Massage: There are more than 80 types of massage therapy, which involves manipulating muscles and other soft tissues of the body to improve circulation and flexibility, reduce stress and promote relaxation, among other benefits. Massage has been shown to effectively relieve musculoskeletal pain in some individuals. In one group of subjects with low back pain who underwent 10 weeks of massage treatment, benefits from massage were still evident a year after treatment.
* Hypnosis: Individuals who undergo hypnosis are induced to enter a state of deep relaxation called a "trance," during which concentration is focused and awareness of external noises and activity is diminished. In this state, the hypnotized person is open to suggestions from a health practitioner that may lead to changes in thoughts, perceptions, behavior, or sensations. Imaging studies have shown the technique can reduce activity in brain regions responsible for pain perception.
* Mind-body techniques: Significant pain reduction may be achieved in some people by harnessing the power of the mind to address bodily pain. Mind-body practices include techniques such as guided imagery (in which pleasing mental images are used as a distraction from pain and a means of promoting relaxation), meditation, progressive muscle relaxation, and yoga. They are thought to stimulate the brain's production of endorphins.
* Neurofeedback: Research has shown that chronic pain can be reduced by training the brain to function within certain brain wave frequencies. A patient is connected by sensors attached at the ear and scalp to a computer graphic display that represents his or her brain waves. Patients are trained to modify their brain waves to achieve specific changes in the display while they watch. To decrease chronic pain, patients learn to decrease activity in a region of the brain believed to process the perception and regulation of pain.

WHAT YOU CAN DO
Follow these suggestions offered by the National Center for Complementary and Alternative medicine (NCCAM) when you look for complementary medicine health care:
* Gather information about the type of therapy you are considering from sources such as professional organizations, academic Web sites, and publications.
* Check with your insurance company to determine whether the therapy you are interested in is covered.
* Discuss the therapy with your primary health care provider and ask for a referral. If your doctor cannot recommend someone, seek a referral from a professional organization.
* When considering a complementary therapy practitioner, ask about the person's training, credentials, and experience.

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Fibromyalgia Patients: A Real Pain in the Muscles and Fibers
Dynamic Chiropractic, Jun 3, 2008 Bomar, John R.

They usually come in "hurting all over." They often are depressed, discouraged and not sleeping well. They frequently arise stiff and sore in the morning, feeling fatigued. They have suffered bouts of irritable bowel symptoms. They appear anxious and feel chronically "burned out."

According to the American Academy of Rheumatology (ACR), 3 million to 6 million Americans suffer from some form of the disorder fibromyalgia. A majority of them are women of childbearing age. However, fibromyalgia also can affect children, the elderly and men.

Conventional Wisdom
Fibromyalgia is characterized by widespread muscle, ligament and tendon pain, chronic fatigue and multiple areas of trigger-point tenderness. The condition was recognized in previous generations, but was known by other names such as muscular rheumatism, fibrocitis and tension myalgia.

Allopathic medicine does not recognize a cause for fibromyalgia. Current thinking centers on internal imbalances that cause an increase in sensitivity to pain signals. Sleep disturbance, past injury, infection, metabolic muscle changes, hormonal imbalance and stress are other considerations in the etiology of fibromyalgia. Interestingly for chiropractors, abnormalities of sympathetic nervous system function also have been postulated as a factor in its etiology.
Diagnosing fibromyalgia can be difficult, as it can mimic many other disorders. The ACR has established the criteria of at least three months of chronic widespread pain and tenderness in at least 11 of 18 specific trigger-point sites.

Medical treatment involves recommendations for aerobic exercise such as swimming and walking, heat and massage treatments, antidepressant and analgesic/muscle relaxant medications, sleep aids, physical therapy and relaxation techniques of guided imagery. Many physicians also recommend stress-management strategies, improved diet and a healthier lifestyle.

Alternative/Holistic Perspective
Many in the alternative health care community see systemic toxicity as a fundamental consideration in fibromyalgia. They believe physiological disturbances from impaired heart, liver, lung and kidney function are at the root of the problem. As we know, the liver and kidneys are the primary detoxifiers of the body. Thus, systemic toxicity (autointoxication) can be the end result of impaired function in these organs.
As specialists in neuromusculoskeletal disorders, we can forget that life itself, as we know it, is basically an electromagnetic phenomenon. In the East, they describe this essential internal energy reserve as qi. Some even see the liver and kidneys as akin to batteries of the body, with the liver serving as the positive pole and the kidneys as the negative. When these organs are deficient in functioning, the body's "battery" is said to be run down. Chronic fatigue, low vitality and organic depression are the result, features common in fibromyalgia patients.

Just as the internal composition of a regular battery can influence its charge, the inner atmosphere of the human body can influence its vitality and strength. Scientific evidence increasingly points to the fact that, for maximum health and wellness, we should be primarily vegetarians, with fruits and vegetables making up the great majority (70 percent to 80 percent) of consumed food. Good-quality grains, nuts and oils, dairy and lean meats should make up the other 20 percent to 30 percent. This has an anti-inflammatory effect and creates an alkalized internal atmosphere, which also produces the health benefit of discouraging reproduction of most pH-dependent human pathogens that are acid-loving.

Therapeutic Regimen
Systemic toxicity demands that primary attention be given to the basic processes of adequate hydration and increased eliminations. My personal observation is that very few patients consume sufficient water for bodily needs, which is estimated to be at least 64 ounces (eight glasses) daily. They tend to try and substitute colas, teas and coffee, all of which are diuretic, resulting in little or no net fluid gain. Almost all human biochemical processes require hydrogen. Without sufficient hydration, these processes slow, contributing to fatigue and accentuating the accumulation of metabolic wastes. Under- or frank dehydration also slows bowel motility, which contributes to reabsorption of toxic waste into the general circulation. "Water is medicine" is my advice to these patients, along with a cleansing diet of fresh fruits and vegetables. Enemas and laxatives also might be useful in internal cleansing, especially if a patient has been constipated. For the most severe cases of long-standing autointoxication, I recommend patients consider a series of colonic irrigations.
Manual therapy (spinal adjustment and massage) will prove very beneficial to most sufferers of fibromyalgia. Spinal biomechanical lesions and nerve "impingements" almost always reflexly stimulate some degree of associated regional muscular spasm, which leads to a relative ischemia and toxemia in and around the tissue. Chronic, longstanding myospasm creates adhesions, scarring and fibrosis.

In applying any form of manual therapy to those with fibromyalgia, one should take great care in the early stages. Since these patients have heightened sensitization to pain, overly aggressive, hamfisted approaches to treatment often will backfire, creating such additional suffering pain as to lose a patient. In the early days, many osteopaths and chiropractors recommended sustained anti-inflammatory measures such as repetitive cold packs and a series of hands-on massages before even attempting spinal manipulation for those with severe pain syndromes.

In recommending dietary changes to patients, I have found it beneficial to discuss the "opportunity of illness." While this sounds counterintuitive, I explain that the reason for the pain signal is to alert them to the underlying condition that needs to be changed for the better. I believe most frank pathology is the result of long-term imbalance in normal physiology, often caused by errors in diet and lifestyle and exacerbated by past injury or chronic inflammation.

Some form of moderate exercise such as walking or swimming is essential to recovery from fibromyalgia. Also frequently beneficial is the discipline of yoga-type stretching. Being out in the open as much as possible while exercising has been shown to be superior to time spent inside on the treadmill. Both walking and swimming mobilize needed lymphatic flow in the body. Arm swings pump this "dirty seawater" back into the veins under the clavicle, where it eventually is cleansed. Of course, the skin and lungs play an important role in metabolic waste elimination as well, so heating a well-hydrated body (hot baths, sauna) to create increased heart rate, perspiration and aerobic breathing also is beneficial.

Finally, "the mind is the builder, or the mind is the slayer" is a wellrecognized axiom that acknowledges the health or disease effect of attitude and emotion. Fear-filled, angry folk who habitually engage in what motivational speaker Zig Ziglar called "stinking thinking," eventually pay a price in their body's lack of wellness. Taking in lots of information that creates distress and inner turmoil, while feeling completely helpless to improve the situation, is what Hans Selye (who coined the term stress) called "pathologically alarming" to us human animals. Conversely, time spent in reading and positive thought of our highest purposes and ideals can contribute substantially to the healing process.

Fibromyalgia can be healed and left behind in a person's life experience. Recognizing its multi-faceted causes and taking a comprehensive approach to its treatment is essential to success in your efforts as true healer.
BY JOHN R. BOMAR, DC
DR. JOHN R. BOMAR is a 1978 graduate of Palmer College of Chiropractic. A past board member of the Arkansas Chiropractic Association and the Arkansas Chiropractic Educational Society, he maintains private practices in Arkadelphia and hot Springs, Ark. He can be contacted at johnrbomar@ hotsprings.net.
Obligatory Disclaimer: The FMS Community does not endorse the use, or non-use of any alternative therapy and/or supplement. Our role is to gather, check and pass on medical information our readers may find useful in planning their health care routine. As always, consult with your health care team before adding new treatments to your routine.


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