Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain

Chapter 4

Mind over Matter

“Freedom from pain should be a basic human right limited only by our ability to achieve it.”
Arthur Lipman, Pharm.D. (Speaker at the November 2001 American College of Rheumatology Symposium)

Chronic pain,  regardless of  the origin,  affects  a person’s whole being  in one aspect or another. Learning what one  can do  to be  emotionally, mentally, physically, and spiritually complete will result  in an amazing outcome.

My Body is Matter and it Matters--Treatment

The pain of FM  and CFID  is  thought  to be  central pain associated with a messaging problem in the central  nervous  system. The  origin  of  pain  in Chronic Myofascial Pain  (CMP)  is  related  to  “trigger points” in the muscles.
    Pain intolerance happens when you are bombarded by painful  stimuli or  impulses. As a result, your other body  systems  start  to  break  down.  Severe  pain  can become so extreme that it causes vomiting, or can cause total decompression, losing all defense mechanisms and touch with  reality. Chronic pain can be  life  threatening when it reaches proportions of great magnitude.
    Treatments  for  FM, CFID, and CMP may not totally  eradicate  the  pain,  but  there  are  approaches that  can help decrease  the  severity of  their pain  to a tolerable  level.

Supplements, Herbs, and Vitamins

Buyer  beware!  There  are many  claims  that  supplements  can  cure  FM  and  CFID.  If  this  were  the case,  those  two disorders would not be  in  this book. Experimenting with supplements can be a very costly venture;  however,  some  people  do  report  some  benefits from their use. Therefore, as long as people claim a benefit from supplements, herbs, and vitamins, others will try them as well. We tend to listen to anyone reporting good news on treating chronic pain.
    There  are  some  dos  and  don’ts  in  trying  over the-counter  (OTC)  herbs  and  supplements. Avoid combination  remedies  to  enable your  assessment of the exact ingredient. Be alert, these remedies are not regulated  by  the  FDA  and  safe  doses  and  interactions have not been  studied  sufficiently. They may have  unwanted  side  affects  or  could  be  potentially dangerous to you.
    Herbal  remedy users  are not  as  knowledgeable about  these  products  as  they  should  be.  I  would suggest  speaking with your physician  and pharmacist  first. Quite honestly,  I have  found only one  to be beneficial, and  it has helped me with one of my coexisting  conditions  rather  than  the  FM, CFID, or  CMP.  I  have,  however,  heard  testimony  from some of my online-support  friends  to  the contrary. Remember, we  are  all  unique,  have  different  reactions  to  different medications,  and  have  different coexisting conditions.

Hints for safe use of supplements, herbs, and vitamins:

- Read labels for content, storage, guidelines, and dosage.
- Research  and  ask  questions  regarding  purity and  potency. Also,  keep  in mind  that  dosages commonly  suggested have not necessarily been tested. Manufacturers are not required  to meet FDA guidelines.
- As with any medication, if you develop hives or wheezing after taking any herbs or supplements, get immediate medical help.
- Don’t  take  unnecessary  risks.  If  you  are  pregnant,  breast-feeding,  on  chemotherapy,  undergoing surgical procedures, have other underlying health issues, or take other medications, discuss your use of OTC medications, herbs, and  supplements  with  everyone  who  needs  to  know. Make  sure your pharmacist has a complete up to-date  list  of  all  your medications  including any OTC preparations you use.

    An  excellent  resource  for  checking doses,  interactions,  and  safety  for  the  use  of  herbs,  vitamins,  and other supplements is http://www.wholehealthmd.com.

Acceptance

Acceptance  is one of  the  steps  in  the  grieving process  that  can  have  a  profound  affect  on  the  way we  look  at  our  illnesses. When we  reach  this  level of  coping  with  our  losses,  then  we  can move  on. In  a  study  done  by Viane,  et  al., the  researchers found evidence  that “acceptance of pain  is an  independent  predictor  of mental well-being  in  patients with  chronic pain.” The  conclusions of  their  study showed  that once chronic-pain patients accept  their pain and the fact that it might not change, they can and do shift away from “pain to non-pain aspects of life.”

Pain-Management Therapies

There  are  two  important questions  to  ask  regarding therapies;  number  one,  “How  you  do  them?”  and number two, “Which one is right fit for you?” A valuable therapy is one that fits your personality and your individual needs. If  it  feels right, you are more  likely to stick to it and thereby reap the benefits.

Acupuncture

Acupuncture  is  an  ancient  Chinese  therapeutic  approach  using  strategically  inserted  needles to  unblock  healing  energy.  This  energy circulates through  the  body  in  predetermined  meridians. Acupuncture points are believed to stimulate release of  chemicals  into  the  muscles,  spinal  cord,  and brain. These chemicals either change the perception of pain or release other chemicals that influence the body’s  ability  to  create  a  system of  checks  and balances. There  has  been  reported  success  in  the  use of acupuncture  for  the  treatment of  illness, chronic disorders, and pain.
    True acupuncture using meridians may not benefit  people with CMP;  however,  if  the  technique  is used  to  treat  trigger points  specifically,  acupuncture may  be  beneficial. The  conduction  of  electromagnetic  signals are  relayed  faster with acupuncture and are believed  to  initiate  the  flow of pain-killing body chemicals,  endorphins. The  signal  calls  for  a  faster response  from  the  immune  system  when  cells  are damaged due to injury or disease.
    Studies  have  shown  that  there  are  changes  in brain chemistry and that sensation and  involuntary body functions occur because of the release of neuro \ transmitters  and  neurohormones  during  acupuncture. It has the potential to affect immune reactions, blood pressure,  blood  flow,  and  body  temperature. It  has  been  helpful  in  treating  some  patients with FM.
    One  study  using  a  SPECT  (single-photon  emission  computed  tomography)  scan  detected  changes in cerebral blood flow associated with pain. The scan also recorded that acupuncture analgesia is associated with changes in the activity of the frontal lobes, brain stem, and thalami. The results of studies like this are promising.

Foreword by Devin J. Starlanyl

Preface

Acknowledgments

Introduction


1    Fibromyalgia Pain, Chronic Fatigue Immunodysfunction, and Chronic Myofascial Pain from Trigger Points   

All about Fibromyalgia
Summary Exercise: FM

Chronic Fatigue Immunodysfunction--The Muster to Master
Summary Exercise: CFID

Chronic Myofascial Pain--Nerve to Muscle
Summary Exercise: CMP

Chapter Summary: FM/CMP–FM/CFID--Is It a Double Cross?

Glossary of Terms Introduced in Chapter 1 that Describe Pain

2    Communicating Your Health Care Needs  

Relating Your Symptoms and Health History

Identifying Aggravating and Alleviating Factors

Coexisting Conditions

Communicating with Your Physician and Other Health Care Providers
Summary Exercise: Clear Expressions

Useful Tools for Communicating with Health Care Providers
Medication Log
Symptom Inventory Sheet
Anatomical Diagram of Pain
Health History Log

3    Dialogues Within and Without

Journal Writing: An Internal Dialogue

Soliciting the Support You Need
Sample Letter Soliciting Support

Relationships: Having Them, Keeping Them, and Knowing When to Let Them Go

Advocacy--A Constructive Way to Vent
Summary Exercise: Reaction to Interaction

Useful Tools for Inner and Outer Self-Expression
A Baker’s Dozen: Thirteen Tips for Expressing Your Feelings through Poetry
Interactive Pain/Energy Meter
It Takes Two to Tango: Rules for Possibly the Most Important Date in Your Relationship
Sample Advocacy Letter

4    My Body Is Matter and It Matters

Understanding and Treating Pain

Managing Your Diet

Exercise--Use It or Lose It

Bodywork--Toiling over the Anatomy

Medical Specialists and Therapists

Health and Functionality Therapists

Chapter Conclusion
Summary Exercise: Exercising Your Options

Useful Tools for a Healthy Lifestyle
Diet Assessment Guide
Stretches for Every Part of Your Body

5    The Power of Mind, Body, and Spirit

Depression--Overcoming the Doldrums

Spirituality

Accepting What Is

Other Paths

Chapter Conclusion
Summary Exercise: Expanding Your Options

Useful Tools for Connecting with Your Spiritual Center
Breathing Meditation for People with FM, CFID, and CMP
Guided Meditation for Healing
New Thoughts on Insomnia

6    Dealing with Circuit Overload

Brain Fog--Symptoms of Blowout before a Power Failure

Time Management--An Exercise in Energy Conservation

Crisis Management--Dealing with Major Life Events

Chapter Conclusion
Summary Exercise: Unloading the Gray Matter

7    Aproaching the System Systematically

The ADA and the EEOC

Social Security Disability Determination

Patient Rights

Miscellaneous Programs and Help

Confidentiality and HIPAA

Chapter Conclusion

Useful Tools for Navigating the Health Care System
Interaction Worksheet for Important Calls and Meetings
Treating Health Care Provider Log
Chronological Health Record
Table for Determining Disability Status for Those Limited to Sedentary Work
Table for Determining Disability Status for Those Capable of Light Physical Work


Epilogue

Resources for Maximizing Health Care, Relationships, and Emotional Well-being

Glossary of Acronyms   

Notes   

About the Authors   

Index 

Celeste Cooper, R.N., worked as a nurse and nurse educator for more than 20 years before being diagnosed with fibromyalgia, chronic myofascial pain, and chronic fatigue syndrome. She is now an advocate for sufferers of these disorders and lives in Missouri and Arizona. Jeffrey Miller, Ph.D., is a psychologist specializing in chronic illness from a spiritual perspective. He lives in Missouri.

“This integrative holistic approach to these conditions is what is needed throughout medicine today. Empowering us to become part of our own health and healing process is such a powerful approach to these conditions or any others. I applaud the authors, and hope they inspire others to follow their lead.”
Bill Douglas, author of The Complete Idiot’s Guide to T’ai Chi & Qigong

“Fibromyalgia, chronic fatigue immunodysfunction, and chronic myofascial pain are the most common illnesses of modern society. I have worked full time in this area since I was trained by Travell and Simons in 1988. This book is not only an easy-to-use self-help book for patients but also an essential reference for any health care practitioner wanting to treat the cause of illness, rather than treat the symptoms. It is totally comprehensive and carries the passion and healing energy of the authors in every page. This is the basis of the medicine of the twenty-first century.”
Dr. John Whiteside, MBBS, BSc, Fellow of the Australian College of Nutritional and Environmental Medicine

“. . . very comprehensive and I highly recommend it for anyone searching for a balanced approach for the treatment of these diseases.”
Dhara Lemos, Lotus Guide, November 2011

HEALTH / BODYWORK

“Fibromyalgia, chronic fatigue immunodysfunction, and chronic myofascial pain are the most common illnesses of modern society. I have worked full time in this area since I was trained by Travell and Simons in 1988. This book is not only an easy-to-use self-help book for patients but also an essential reference for any health care practitioner wanting to treat the cause of illness, rather than treat the symptoms. It is totally comprehensive and carries the passion and healing energy of the authors in every page. This is the basis of the medicine of the twenty-first century.”
--Dr. John Whiteside, MBBS, BSc, Fellow of the Australian College of Nutritional and Environmental Medicine

Fibromyalgia, chronic myofascial pain, and chronic fatigue are often seen as interchangeable conditions, a belief held even by many health care providers. Nothing could be further from the truth--however, they do often coexist. Knowing if more than one of these disorders is present is extremely important, because the treatment for one of them can often exacerbate the problems caused by the others. Written by a registered nurse and a psychologist who has been treating these conditions since 1994, this book presents an integrative medical approach to these three disorders with a strong emphasis on utilizing and strengthening the mind-body connection to restore well-being.

The authors begin with clear diagnostic guidelines for each condition and reference the latest scientific research on what causes these illnesses. Because many medical practitioners are relatively unfamiliar with these disorders, it can take several medical visits to arrive at a definitive diagnosis. Clear communication with medical personnel is key to diagnostic success. This book provides invaluable advice on how to describe symptoms, document health history, and keep a log of medical appointments. Included are interactive worksheets to facilitate these activities. The authors provide a thorough guide to numerous treatment options--from diet, exercise, and herbs to mindfulness meditation, yoga, and nonsteroidal anti-inflammatory drugs (NSAIDs). They also offer techniques to dispel the “brain fog” that these illnesses can create, offer guidance on the psychological issues that accompany these chronic pain disorders, and provide advice on how to build a personal support team. The final chapter gives advice on how to navigate the health care system, including step-by-step instructions for preparing an application to the Social Security Administration for disability benefits. An extensive resource section provides a wealth of contact information for helpful agencies and organizations, good sources for medical supplies, and a wide selection of suggested further reading. In short, this integrative treatment guide will open the door not only to physical recovery but also to emotional, mental, and spiritual well-being.

CELESTE COOPER, R.N., worked as a nurse and nurse educator for more than 20 years before being diagnosed with fibromyalgia, chronic myofascial pain, and chronic fatigue syndrome. She is now an advocate for sufferers of these disorders and lives in Missouri and Arizona. JEFFREY MILLER, Ph.D., is a psychologist specializing in chronic illness from a spiritual perspective. He lives in Missouri.