Alternative Treatment for Fibromyalgia

Many people with fibromyalgia also report varying degrees of success with complementary and alternative therapies, including massage, movement therapies (such as Pilates and the Feldenkrais method), chiropractic treatments, acupuncture, and various herbs and dietary supplements for different fibromyalgia symptoms.

Though some of these supplements are being studied for fibromyalgia, there is little, if any, scientific proof yet that they help. The FDA does not regulate the sale of dietary supplements, so information about side effects, the proper 12 dosage, and the amount of a preparation's active ingredient may not be well known. If you are using or would like to try a complementary or alternative therapy, you should first speak with your doctor, who may know more about the therapy's effectiveness, as well as whether it is safe to try in combination with your medications.

Biofeedback

Although no definitive finding links biofeedback with improvement of fibromyalgia symptoms, the therapy has been shown to alleviate a range of health problems such as migraine headaches and high blood pressure.

In an Italian study, six people with fibromyalgia were selected to receive electromyographic-biofeedback training (EMG-BFB). The volunteers took part in fifteen 20-minute sessions scheduled twice a week . Their results were compared with a control group of six other fibromyalgia sufferers.

The volunteers were hooked up to devices that included electromyographs and speakers. The electromyograph measured muscular tension in the muscles of the forehead, and the speakers produced audible pulsing sounds that correlated to the degree of muscular tension. The sound allowed each volunteer to learn how his or her own body relaxed with certain thoughts and tensed up with others. Participants were asked to close their eyes, relax, and slow down the pulses. With time, they learned how to slow down the audible pulses and control muscular tension. The participants were also asked to attempt the relaxation at home, without the use of the machine. At the end of the study period, those participating in EMG-BFB training reported decreased pain, decreased morning stiffness, and improvement on a questionnaire that assessed general symptoms, such as headaches and irritable bowel syndrome. The control group reported no improvement. One clinically depressed participant did not report improvement (1).

Given the possible role of stress in fibromyalgia, any measure that reduces stress may provide some improvement in symptoms. The benefits of biofeedback for fibromyalgia are only now being critically studied as a means to control stress. Thus far, comparative studies have not been done on stress-reducing strategies such biofeedback and meditation, so no single strategy can be shown to be most effective. The Italian study's small sample size and lack of standardized criteria for judging improvement prevent a definitive recommendation of biofeedback as standard therapy for fibromyalgia; also, the study’s authors were unable to explain how EMG-BF improved fibromyalgia patients symptoms.

Biofeedback has gained respectability and some scientific credibility in treating certain health problems such as migraine headaches and high blood pressure. Still, it has the potential to be misused because anyone can purchase a device and market him- or herself as an "expert." Before paying for and undergoing biofeedback therapy, ensure the provider has some experience in health care.

Hypnosis

Hypnosis is sometimes used to treat asthma, irritable bowel syndrome, and ulcers. Although it may be effective in controlling the sensation of pain in people with fibromyalgia, further study is necessary to determine its benefits for the fibromyalgia sufferer.

A study in the Netherlands randomly assigned 40 fibromyalgia patients to either a three-month course of hypnotherapy or a three-month course of physical therapy (2). Since each of the participants had used physical therapy in the past, the physical therapy group was considered the control group. The hypnosis group participated in eight one-hour sessions over three months and used a half-hour audiocassette tape daily. In using hypnotic suggestions in person and on tape, researchers intended to control muscle pain, relax the subject, and improve sleep.

At the end of the three-month therapy and three months after the treatment, an independent observer evaluated each participant. Participants were evaluated for several criteria: duration of morning stiffness, muscle pain, fatigue upon wakening, sleep disturbance, overall health, and scoring on the Hopkins Symptom Checklist, a test for bodily and emotional discomfort. During both evaluations, the hypnosis group reported subjective improvement over the physical therapy group. The hypnosis group reported a 25% reduction in morning stiffness, a 10% reduction in muscle pain, a 16.7% reduction in fatigue upon wakening, and a 33% increase in overall health. The physical therapy group remained unchanged.

Objective findings in the study, such as the number of tender points and degree of muscle pain, did not change. Those findings support the idea that hypnosis helps fibromyalgia sufferers cope with the disease but does not alter the underlying problem or cause.

Acupuncture

The Chinese have used acupuncture to treat a variety of disorders for thousands of years. Studies have shown acupuncture is effective in raising the pain threshold for several pain-related disorders, and at least one study has found that acupuncture may benefit those with fibromyalgia (3).

In a Swiss study, reported in The British Medical Journal, researchers randomly assigned 70 volunteers with fibromyalgia to receive six sessions of either electroacupuncture or a placebo procedure. For the electroacupuncture group, needles were placed at sites on the body, and a small electrical current was then applied to the needle

After three weeks, when all six sessions were completed, the electroacupuncture group reported improvement on a wide variety of measures, including decreased reliance on analgesic medications, decreased regional pain score, and improved sleep quality. The pain threshold for the electroacupuncture group increased by 70%, while the control group’s threshold only increased 4%. Morning stiffness did not improve in either group. Six out of the 35 members of the electroacupuncture group dropped out because their symptoms increased and the discomfort of acupuncture needle insertion.

Chinese medicine and Western medicine each have different ways of explaining how acupuncture works. According to traditional Chinese medical principles, acupuncture helps balance the body's life energy, or "chi," by placing the needles at specific points that correspond to "meridians" or energy fields within the body.

Operating under a different paradigm, Western medical science has shown acupuncture's analgesic effect is due to endorphin release within the spinal cord. Some evidence suggests that during acupuncture adrenocortotropic hormone release from the brain and alterations in serotonin release may provide some analgesia (4).

Acupuncture's effectiveness in long-term management of fibromyalgia has not yet been studied. The general experience with acupuncture is that the beneficial effects are short-lived, on the order of two to four hours. If you decide to seek acupuncture treatment for your fibromyalgia, find an acupuncturist who has graduated from an accredited program and for whom you can find favorable references.

Meditation

Meditation has been shown to help reduce the severity of fibromyalgia symptoms. In a 1993 General Hospital Psychiatry study, 77 fibromyalgia sufferers were divided into groups of seven to 12 who met for weekly two-hour meditation sessions for 10 weeks (5). The program focused on issues of greatest concern to fibromyalgia patients, including pain, sleep, and fatigue. Participants were also asked to keep a personal journal, listen to audiotapes on meditative posture (sitting) and imagery, meditate twice a daily, and complete “mindfulness” homework. The homework’s purpose was to help them observe their thoughts and feelings objectively so that they could gain control over them. The therapy was aimed at examining the need to be “friendly” to oneself, as well as reactions to physical stress and social stress, such as is found in the workplace and at home.

At the beginning and end of the study, researchers assessed each participant’s overall health using scales to measure pain, sleep, fatigue, fibromyalgia symptoms, and subjective feelings. About half of those (51%) completing the study reported at least a 25% improvement on half of the scales. Seven of the 59 who completed the study improved by more than 75% on each scale.

One limitations of the study is a potential selection bias in which only those who were capable and motivated to take part in a regimented program requiring “homework” were included. The study was not controlled, meaning there was no comparison group, so some improvements seen could have been due to some other factor besides meditation. There was also no follow-up data.

Meditation is a cognitive approach that promotes awareness of thought processes. Individuals with fibromyalgia may benefit from the mindfulness approach by learning to better understand their own cognitive and emotional reactions to pain. Though they still sense pain, the pain no longer has the same destructive impact on the emotions and the sense of self. Meditation may be integrated into people's lives as a way to control the symptoms of fibromyalgia, but its proven benefits await further study.

References

  1. "EMG-Biofeedback training in fibromyalgia syndrome," by G. Ferraccioli et al, The Journal of Rheumatology, Vol. 14, No. 4, 1987, pages 821-825.
  2.  "Controlled Trial of Hypnotherapy in the Treatment of Refractory Fibromyalgia," by H.C.M. Haanen, The Journal of Rheumatology, Vol. 18, No. 1, pages 72-75.
  3. "Electroacupuncture in fibromyalgia: results of a controlled trial," by C. Deluze et al, British Medical Journal, Vol. 305, 1992, pages 1252-1256.
  4.  "Nonmedicinal treatments in primary fibromyalgia," by G.A. McCain, Rheumatic Disease Clinics of North America, The Fibromyalgia Syndrome, Vol. 15, pages 73-89.
  5. "The impact of mediation-based stress reduction program on fibromyalgia," by K. Kaplan and D. Goldenberg, General Hospital Psychiatry, Vol.15, 1993, pages 284-289.

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Last updated: 5/13/2022