Stress

By Qineng Tan, L.Ac., Ph.D. & Xiaomei Cai, L.Ac., Ph.D.

Do you experience unexplained pain all over the body? Muscle pain and tenderness, along with feeling tired all the time and having mood issues? Widespread musculoskeletal pain accompanied by fatigue or feeling exhausted may be a sign you have fibromyalgia. Alternative medicine methods like Acupuncture and TCM offer a way to help ease the chronic pain, sleep problems, and emotional disturbances caused by fibromyalgia.

Fibromyalgia (sometimes referred to as “fibro” or FM) is one of the most common chronic pain conditions worldwide, affecting an estimated 10 million people in the United States alone. Still, this chronic condition is still not well understood by medical science. There are no definitive tests to show whether or not fibromyalgia is the cause of pain all over the body along with chronic fatigue, so many people go on having musculoskeletal problems and hurting all over without being diagnosed or treated. There are many people who have fibromyalgia who also suffer from depression and anxiety related to the illness. Fibromyalgia can dramatically impact a person’s quality of life. While people of ages and genders can have fibromyalgia, it is much more prevalent among women.

Fibromyalgia is considered to be a syndrome: a collection of symptoms that often occur together. Fibromyalgia is associated with other conditions like lupus, rheumatoid arthritis (RA), myofascial pain syndrome, and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). It may coexist with these other chronic conditions, or sometimes be mistaken for one of them. However, fibromyalgia is now understood by medical professionals to be its own distinct condition with specific manifestations.

People who have RA have been shown to have an increased risk for also having fibromyalgia. But the quality and location of the musculoskeletal pain differentiates the two conditions. The pain of fibromyalgia shows up in the musculoskeletal system in the areas where there are large muscles, causing pain that may move around throughout the torso, back, hips, thighs and arms. Fibromyalgia pain is often described as a kind of “tenderness,” or when the body aches all over. “Tender points” all over the body are specific to fibromyalgia. This is different from arthritis, which generally causes swelling and pain in the joints. Both RA and lupus are understood to be caused by inflammation, while fibromyalgia is believed to be caused by a problem with the central nervous system (CNS), in which pain signals are amplified, causing extreme sensitivity and pain, even when there is no seeming reason for that area of the body to feel pain.

Some of the fibromyalgia symptoms are very similar to those of myalgic encephalomyelitis (ME), which is also known as chronic fatigue (CFS). As with RA and lupus, the two conditions can overlap. The difference is that the overwhelming symptoms of ME/CFS are related to fatigue or post-exertional malaise (PEM), while the predominant symptom of fibromyalgia is widespread muscle pain and tenderness. 

Fibromyalgia seems to show up in some people due to a traumatic or triggering event. There can then be a fibromyalgia flare up due to the presence of other triggers later.

Fortunately, acupuncture, herbs, and other forms of alternative medicine that fall under TCM can approach all of the different symptoms of fibromyalgia holistically. Acupuncture is widely accepted to be effective for helping musculoskeletal conditions of all kinds, as well as neurological problems, rheumatological conditions, sleep issues, and emotional and mental health disorders.

Top 10 Symptoms of Musculoskeletal Pain

As a syndrome, fibromyalgia may manifest as any combination of a few or several of a variety of symptoms. The most common symptoms of fibromyalgia include:

1. Widespread musculoskeletal pain: pain, tenderness, and/or stiffness in the muscles all over the body that may come and go or migrate from one area to another
2. Fatigue, exhaustion, extreme tiredness
3. Emotional and/or mental issues: depression, anxiety, PTSD
4. Sleep problems, insomnia
5. Cognitive issues: difficulty concentrating, memory problems, “fibro fog”
6. Headaches, migraines
7. Neuropathy: tingling or numbness in the hands and/or feet
8. TMJ, jaw pain
9. Digestive problems: irritable bowel syndrome (IBS), abdominal pain, bloating
10. Bladder pain, interstitial cystitis

Other more subtle signs of fibromyalgia can include: itching all over, a skin crawling sensation (like bugs crawling on skin), extra sensitivity to smells or temperature, a tendency to shiver, or dry eyes or eye pain.

Top 5 Causes Musculoskeletal Pain Flares

The symptoms of fibromyalgia tend to come and go. Some days a person might feel almost totally fine, then other days, the fibromyalgia flares, causing more pain, exhaustion, and sometimes other symptoms. What triggers a fibromyalgia flare up? 

1. Hormonal changes during menstrual cycle, miscarriage, pregnancy, or postpartum
2. Prolonged stress
3. A sudden traumatic event, PTSD trigger, panic attack
4. Changes in weather: temperature, humidity, barometric pressure
5. Lack of sleep

When one of the 18 tender points of fibromyalgia is touched, it can trigger more widespread pain. These points include areas like: the front and sides of the neck, the base of the skull, the elbow, and the backs of the knees.

What Is the Treatment for Fibromyalgia?

Medical treatment for fibromyalgia typically involves a combination of medicine to alleviate pain with psychological support and lifestyle management. Drugs like Lyrica, Cymbalta, and Savella are approved for prescription for patients with fibromyalgia. Lyrica and Cymbalta are also used to treat conditions that involve nerve damage or nerve pain, like diabetes, neuropathy, shingles, while Savella works in a way that is similar to antidepressants. Other pain relievers and/or antidepressant medications may also be prescribed to help people manage pain of fibromyalgia, help them sleep better, and boost mood. All of these medications can come with unwanted side effects, and they do not help to relieve pain in every case.

People with FM pain will often receive counseling on how to manage their condition by being very careful not to exert themselves or become exhausted. Getting quality sleep and reducing stress can help to prevent fibro flare up. It can be hard for people to follow guidelines that ask them to make major lifestyle changes. Fortunately, acupuncture, herbs, and the patient support of a TCM practitioner can offer more help for people with fibromyalgia.

Acupuncture for Musculoskeletal Pain

Can acupuncture help fibromyalgia? Yes. TCM offers a comprehensive system for managing musculoskeletal pain and chronic pain, helping to heal nerve damage and restore central nervous system function, supporting mental health, relieving anxiety and depression, and addressing sleep problems. Whereas with conventional medicine, a patient might go from one doctor to another to handle all of these issues, the acupuncturist can address them all at once. The TCM point of view always takes into consideration the connection between what is going on physically with what is going on emotionally in each individual, so it is really an excellent way to help patients with fibromyalgia.

Like Western medicine, TCM recognizes that sometimes fibromyalgia can be originally caused by a traumatic event or an extremely stressful time in one’s life. Emotional upheavals cause stress to the liver, which in turn causes stagnation of blood and Qi. TCM also sees coldness and dampness as pathogenic forces that can have a profound effect on overall health. According to TCM, widespread musculoskeletal pain falls under the category of Bi Syndrome. In Bi Syndromes, cold and damp get into the body and take hold on a deep level, causing pain and stiffness. With acupuncture treatment for fibromyalgia, we seek to clear cold and damp, and restore good flow of Qi and blood throughout the body.

Acupuncture has an analgesic effect, relieving muscle pain without side effects. Moxibustion may be utilized to bring warmth to areas of the body. Cupping is another modality used to draw out damp cold and improve blood flow. Tai Qi and Qi Gong, gentle therapeutic movement practices that have been developed over 1000s of years as part of TCM, also may offer great benefits for people with FM.

A systematic review of over 400 studies of fibromyalgia treatment with TCM, acupuncture treatment was found to be effective for reducing both short term pain and long term pain.

Another review found that acupuncture and herbs worked better to reduce pain than standard medication therapy.

Top 5 Tips for Managing Fibromyalgia

Dealing with fibromyalgia and seeing significant improvement in fibro pain will probably involve making some lasting lifestyle changes. Making adjustments to your sleep habits, food choices, and your exercise routine can make a difference in preventing the next FM flare up.

1. Choose a gentle, enjoyable form of exercise. Start slowly, and gradually increase the amount you can exercise over time. Walking outdoors is a great option, as are Tai Qi and Qi Gong.
2. Limit or eliminate caffeine and alcohol. These substances can interfere with getting good sleep and exacerbate liver problems. Alcohol is not safe to consume if you are taking medications for fibromyalgia like Lyrica, Cymbalta, and Savella.
3. Avoid sugar, which may give you a short-lived good feeling, but will lead to a “sugar crash,” and feeling more exhausted than before. Any kind of simple carbohydrates, like foods made of white flour, or bottled fruit juices, can cause highs and lows in blood sugar. Avoid sugar substitutes and food additives like MSG, which can trigger reactions in some people.
4. Focus on eating complex carbohydrates, especially vegetables. These help you have a more sustained energy throughout the day. Nuts and seeds are also good.
5. Warm baths with Epsom salts can be very soothing. 

Getting enough sleep at night, and even resting or napping during the day, may be essential to your well-being if you have fibromyalgia. Develop habits that allow for plenty of rest and set yourself up for a good night’s sleep. 

Acupuncture Near Me for Musculoskeletal Pain

Many people who have fibromyalgia choose to try alternative medicine as a way of managing FM pain. Physiological conditions that stem from emotional stress are often not resolved through the use of medications. Acupuncture and TCM have a long history of helping people to heal from emotional disturbances that cause physical pain. Acupuncture treatment works to increase the flow of energy through the body and improve the connections between the brain and nerve endings. If you or someone you know suffers with fibro, consider acupuncture as a way to find relief from musculoskeletal pain and constant fatigue.

*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.