Relief for Fibromyalgia Promising: Strategies for Pain Reduction
According to the Mayo Clinic, fibromyalgia is characterized by widespread musculoskeletal pain and fatigue, accompanied by sleep, memory and mood problems. It affects about 4 million Americans and is most often diagnosed between the ages of 35 and 45. Adult women are twice as likely as men to suffer from this chronic, debilitating condition.
“Although the exact cause of fibromyalgia is not known, many researchers have come to believe that it results from an overactive nervous system that misfires, making pain signals stronger and more persistent. It appears that the brain and nerves are not processing pain messages correctly, leading to heightened sensitivity and discomfort. Traditionally, treatments have been focused on managing symptoms rather than addressing the root causes, but exciting advances in medical research and treatment are on the horizon,” says Jane Hogan, a functional medicine certified health coach, founder of the Wellness by Design podcast and host of the Becoming Pain-Free 2.0 Summit last November.
Getting to the Root Cause
Dr. Evan Hirsch, a functional medicine practitioner and CEO of EnergyMD, states, “Fibromyalgia is an autoimmune disease, or at least inflammation, and all inflammation is essentially autoimmune. If that autoimmunity ends up attacking the muscles, you get fibromyalgia. Essentially, the immune system is reacting to something that is in the body. When that something is in the muscles, the immune system is attacking that thing in the muscles.”
Hirsch suggests that the offenders might be a combination of heavy metals, chemicals, molds, infections and nervous system dysfunction. He stresses that if symptoms began after COVID, then it is important to address that infection. Bartonella bacteria, which are spread to humans by fleas, body lice or sand flies, can live in the muscles, causing inflammation—and pain—in the tendons and ligaments.
Stress and the Vagus Nerve
Stress is a major risk factor for many chronic health conditions. According to Hogan, “A key player in calming fibromyalgia pain is the vagus nerve, which activates the nervous system’s parasympathetic state, or relaxation response. A promising area of research is investigating non-invasive vagus nerve stimulation as a safe and effective mode of pain management for fibromyalgia patients. Methods of self-stimulation of the vagus nerve include deep diaphragmatic (or belly) breathing, body movement, reflexology, gargling, humming and cold-water immersion. Trauma can also contribute to chronic pain, so incorporating more mind-body techniques can improve overall health and wellness.”
Low-Dose Naltrexone
Traditionally used for opioid addiction, naltrexone has been studied for its potential to reduce pain and inflammation in fibromyalgia. A 2023 systematic review published in the Journal of Pain Research, reported that low-dose naltrexone appears to be effective and safe in the symptomatic management of fibromyalgia. The researchers noted that additional studies were needed to determine dosage, frequency and duration recommendations.
The Importance of Gut Health
The gut microbiome houses 70 to 80 percent of the body’s immune cells. “Anything that is in the gut that is not supposed to be there, including foods, can cause inflammation, and inflammation in the gut leads to inflammation in other parts of the body, which can cause pain in the muscles and fibromyalgia,” says Hirsch. “Gut health and the health of the microbiome is critical for lowering chronic inflammation and pain.”
He recommends focusing primarily on fiber-rich foods, healthy fats and lean protein, as well as pre-biotic, probiotic and post-biotic foods. Removing ultra-processed foods and common food sensitivities can also help to lower inflammation in the gut.
A fecal transplant from a healthy donor may be beneficial to replace vital gut bacteria; however, the transplant may have to be repeated multiple times over extended periods, says Hirsch. In his experience, patients are unable to keep up the treatments for a variety of reasons. “If they don’t keep doing it, they aren’t going to continue to get the benefits,” he points out.
A New Hope
The world of fibromyalgia treatment is rapidly evolving with new therapies, from regenerative medicine and targeted drug therapies to integrative mind-body treatments. It is exciting to see this new shift toward personalized, effective care that addresses physical, mental and emotional aspects of fibromyalgia, bringing new possibilities for pain relief and an improved quality of life.
Madiha Saeed is a holistic, functional and integrative doctor in Naperville, Illinois, and director of education for Documenting Hope and KnoWEwell.
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