Fibromyalgia: From Diagnosis to Holistic Treatment

Updated: Aug 28, 2020

Fibromyalgia is a common cause of chronic pain. A person diagnosed will have fatigue, muscle pain, and stiffness.


Fibromyalgia has a gradual onset. It is usually related to a history of trauma. Approximately 2-3% of the population have fibromyalgia, affecting mainly women ages 20-55 years old. It is diagnosed clinically which means diagnosis is based on the patient’s story, symptoms, and physical exam, not on positive lab findings. In fact, testing for inflammation will be negative. Fibromyalgia is considered a syndrome, not a disease. A syndrome is a pattern of signs and symptoms, whereas a disease is more specific with pathological changes in tissue. The cause of fibromyalgia is unknown. Some diseases can appear to be fibromyalgia and must be ruled out with additional workup, like rheumatoid arthritis and inflammatory myopathy.


Other potential causes of chronic widespread pain:

• Inflammatory rheumatological disease (RA, lupus)

• Systemic autoimmune disorders

• Polymyalgia rheumatica

• Inflammatory myopathy

• Osteoarthritis

• Localized pain syndromes

• Thyroid disorder


How to diagnose fibromyalgia?


A doctor will “palpate” the body of the patient, a fancy term for investigative touch. If a patient is tender to light palpation, we think this is abnormal and investigate further. If a person is tender in many different areas of the body, fibromyalgia is on the list of possible diagnoses.


A person with fibromyalgia will be tender to light or moderate palpation. For example, pressing lightly on a patient’s shoulder will elicit an “ow!” and will likely be surprising to the person pressing. Fibromyalgia symptoms also include sleep disturbances, fatigue, and sometimes brain fog. They will sleep light, wake unrefreshed and stiff. 30-50% of patients diagnosed with fibromyalgia will have either depression or anxiety. About 50% will have headaches, either tension-type or migraine. Some may experience paresthesias; tingling, burning, numbness, creepy crawly feelings on the skin. Other symptoms include irritable bowel, pelvic pain, and temporomandibular joint dysfunction.


In order to diagnose fibromyalgia, a person will have chronic widespread pain of at least 6 different body areas out of 9. "Body areas" include: left arm, right arm, left leg, right leg, head, and upper back. These areas are without joint swelling or inflammatory physical changes. Symptoms must be going on for at least 3 months (aka "chronic.") Blood work is normal: Complete blood count is normal. Inflammatory markers like CRP and ESR are normal. Other possible causes of widespread body pain are ruled out.


Coexisting problems:

• Irritable bowel syndrome

• Chronic fatigue syndrome

• TMJ

• Migraine

• Interstitial cystitis/ chronic pelvic pain syndrome

• Sleep apnea

• Restless leg syndrome

• Raynaud's syndrome

• Autonomic nervous system dysfunction (orthostatic hypotension, tachycardia, palpitations)


Above is a list of other conditions people diagnosed with fibromyalgia may have.


Fibromyalgia Tender Points & Acupuncture




The common tender points are surprisingly similar to acupuncture points. Some of these areas we call the “sea,” located at the knees and elbows, because there is an abundance of Qi. Qi flows through acupuncture "channels" like water. These areas are also where large amounts of Qi can get stuck, resulting in stagnation and thus pain.







Spiritually, these points may express:

A movement in the direction of ease on the earthly plane; Navigating through life’s obstacles with wonder.


Treatment

Without getting too much into the knitty gritty and speculation of fibromyalgia since its cause is unknown, I’ll tell you what works very well for patients.


Stress & Adrenal Fatigue