By Coach Toria Lee, Certified Personal Trainer (ACSM), Wellness Coach, Exercise Therapist,                                                                          Lifestyle & Weight Management Consultant, President: WellFit Health Solutions

What is Fibromyalgia Syndrome (FMS)?

• Most common rheumatic disorder in the country
• Complex & multi-dimensional, with no apparent cause
• Creates pain in connective tissues including muscles, tendons, ligaments
• Can interfere with activities of daily living & even create disability

Symptoms may include:

• Pain & stiffness are worse in the morning
• Pain is described as burning, throbbing, shooting, stabbing & achy
• Headaches
• Fatigue
• Insomnia & other sleep disturbances
• Skin irritation, numbness, tingling & twitching
• Irritable bowel & bladder symptoms
• Jaw pain
• Premenstrual discomfort & painful periods
• Anxiety & depression
• Heart palpitations
• Memory & concentration impairment
• Dry eyes & mouth
• Changes in eyesight
• Dizziness & coordination challenges
• Increased incidence of infections due to impaired immunity
• Allergies to foods or chemicals
• Specific “tender points” that are painful to the touch
 Area near lower vertebrae of the neck
 Neck muscles connected to the base of the skull (trapezius, sternocleidomastoid, splenius capitis, semispinalis capitis)
 Muscles of upper & mid back (trapezius, supraspinatus)
 Area near insertion of 2nd rib
 Side of the elbow (lateral epicondyle)
 Upper & outer muscles of gluteals
 Upper part of thigh bone (greater trochanter)

Who is affected?

• 5-10 million Americans
• Over 80% are females, ages 20 – 55
• Common among women who are stressed, tense, depressed, anxious & striving
• Females who do not feel safe, covered, protected, nurtured, or who feel insecure, anxious & driven.
Why? Symptoms & Causes

FMS symptoms may be triggered or worsened by various factors.
• Anxiety & depression
• Emotional stress, grief & trauma
• Lack of activity
• Overexertion
• Temperature &/or humidity extremes
• Infectious illness
• Lack of sleep
• Environmental sensitivities
• When a physician does not affirm the patient’s concerns & considers their complaints to be psychosomatic. (Merck Manual)

Possible Root Causes & Theories:

• Disruption in brain chemistry or the brain’s ability to process pain
• Neuroendocrine & autonomic system regulation (hypoglycemia, hypothyroidism)
• Possible genetic defect that interferes with the formation of ATP (adenosine triphosphate) which is the source of cellular energy)
• Immunological disorder
• Muscular abnormalities
• History of emotional, mental or physical abuse
• Infection by Epstein Barr Virus or Candida Albicans
• Mercury poisoning from dental fillings
• Connection with Chronic Fatigue Syndrome
• Low self-esteem & social isolation
• Poor quality of life
• Poor physical fitness &/or impaired functional ability
• Disturbance in sleep patterns
• Anemia
• Parasites

Potential Solutions to Overcome Fibromyalgia

Nutritional Guidelines

• Eat a balanced diet of natural foods that consists mostly of fruits, vegetables, whole grains (millet, quinoa, brown rice), nuts & seeds, soy products (unless allergic), skinless turkey or chicken & fish.
• Eat 4-5 small meals per day
• Drink plenty of liquids to help flush out toxins. Include steam distilled water, herbal teas & fresh vegetable juices.
• Avoid foods that are high in saturated fats, like red meats, dairy products, fried & processed foods & shellfish. Saturated fats increase cholesterol, interfere with circulation, may induce inflammation & increase pain.
• Avoid caffeine, alcohol & sugar in any form. If these items have been a regular part of your diet, then you may experience worsening of symptoms due to withdrawal. As your body finds a healthy new homeostasis, your symptoms will improve.
• Avoid wheat & brewer’s yeast until symptoms improve.
• Limit consumption of tomatoes, green peppers, eggplant & white potatoes.
• Include pomegranates which have anti-inflammatory & antioxidant agents.

Lifestyle Modification & Alternative Therapies

• Maintain a daily program of moderate activity. (See following guidelines.)
• Get sufficient rest (7-8 hours of sleep).
• Practice relaxation techniques in the evening & avoid looking at a computer screen which interferes with your body’s natural production of Melatonin.
• Consider using a wheatgrass enema to detoxify the body (1 ounce wheatgrass juice & 1 cup warm water).
• Consider getting a colonic to cleanse your colon & improve nutrient absorption.
• Take a hot shower upon rising to relieve muscular stiffness. Cold showers have been shown to relieve FMS pain, so consider alternating between hot & cold water while showering.
• Chiropractic adjustments which can correct spinal subluxations & acupuncture may help relieve symptoms.
• Consider massage therapy, exercise therapy, deep heat therapy, aromatherapy or essential oils & FAR Infrared saunas for relaxation & detoxification.
• Have your thyroid checked since symptoms of hypothyroidism are similar to FMS.
• Get checked for food allergies.

Nutritional Supplements to Enhance Health & Relieve Symptoms

• Juice Plus (whole food nutrition; provides 17 servings of fruits & vegetables in capsules)
• Acidophilus &/or bifidus – improves gastrointestinal health
• CoQ10 – improves oxygenation, immune system & cellular energy
• Lecithin – enhances energy, immunity, circulation & brain function
• Calcium/Magnesium/D3 – enhances neuromuscular health; relieves muscle spasms & pain. People with FMS are often deficient in               Magnesium.
• MSM (methylsulfonyl-methane) – supports joints & connective tissues; reduces pain
• NADH (nicotinamide adenine dinucleotide) – increase energy
• Proteolytic enzymes – improves absorption of foods & reduces inflammation
• DMG (dimethylglycine) – enhances oxygenation & reduces free radicals
• 5-HTP – enhances serotonin which may help relieve depression & pain
• SAMe – helps relieve depression, stress & pain
• B complex injections – increases energy & healthy brain function
• Essential fatty acids – protects cells; helps reduce pain & fatigue
• L-Tyrosine – helps to relieve depression & relax muscles.
Combination formulas that contain a synergistic blend of some of the above nutrients are also available.

Physical Activity: Keep Moving toward a Healthier Quality of Life

There are many benefits of activity & exercise therapy to help individuals overcome symptoms related to fibromyalgia including:
• Reduced number of tender points & decreased pain at tender points
• Decreased general pain
• Improved sleep & less fatigue
• Increased self-efficacy & positive attitude
• Increased frequency & quality of social interactions
• Reduced impact of symptoms on daily activities

Since most individuals with FMS begin from a deconditioned, inactive state, & should begin an activity program with lower levels of intensity, duration & frequency, then progress slowly. It is best to do some activity on most days of the week. Participants may experience an increase in symptoms at the onset of beginning an activity program, but benefits will accrue over time, if a program is maintained progressively & consistently.

Research has shown a high attrition rate among participants with FMS, so it is important to maintain realistic expectations & set small, attainable goals. It is also important to combine an activity program with other supportive modalities such as nutrition & lifestyle modification, cognitive behavioral therapy, medication, support groups & education programs. Therapy or wellness coaching that focuses on enhancing self-efficacy may be especially helpful. Self-efficacy has been shown to be the most important predictor of activity initiation & maintenance. Group fitness & guidance from a qualified Personal Trainer or Exercise Therapist may help to provide accountability & adherence.

Physical Activity Guidelines

Aerobic activity
• Type: Walking, biking, aquatics
• Duration: 20-40 minutes
• Intensity: low-moderate (50-75% HRR)
• Frequency: 2-3 days/week
• Duration is more important than intensity

Aerobic activity goals
• Restore or maintain functional ability
• Decrease pain
• Decrease anxiety & depression
• Increase VO2 max
• Increase speed & distance ability
• Increase time to exhaustion

Strength
• 1 set of 8-12 repetitions
• Begin with 40% of 1 Rep Maximum (RM), progress to 60-70% 1RM
• Pause between repetitions
• Minimize eccentric phase (negative or return phase)

Strength goals: Maintain or improve muscle strength

Flexibility movements are especially important in improving FMS symptoms & should include gentle stretches that are well-tolerated. All major muscle groups should be stretched through a comfortable Range of Motion. Stretches that are held for short periods of 2-3 seconds & repeated 5-10 times have shown good results.

Flexibility goals: Increase Range of Motion

Functional Activities should be individualized & lifting-specific.
Functional activity goals:
• Increase ability to perform daily activities
• Restore work potential
• Improve quality of life

General activity goals for improving symptoms related to fibromyalgia include:

• Reduce sensitivity & number of tender points
• Reduce pain
• Improve sleep
• Improve psychological well-being
• Avoid exhaustion

Activities to avoid:

• High-impact or vigorous activities
• Sustained overhead activities
• Eccentric muscle contractions
• Morning exercise (due to common morning stiffness)
• Extended bouts of exercise on a standard bicycle due to tender points on the gluteal muscles. A recumbent bike is better tolerated.

Spiritual Insights from Henry W. Wright, author of “A More Excellent Way to Be in Health”

According to God’s word, men are designed to be the spiritual head of the home & protect the wife, without being oppressive or domineering. When men do not step up to lead their families, if they abuse their wives or children, or do not affirm them, then he violates the order that places him as the protector, & his family has nowhere to turn. A common root of stress & anxiety can be found when:
 Woman are not nurtured or covered with protection;
 When she must assume the role of spiritual head of the household;
 When a woman is driven by ambition or has tendencies toward perfectionism;
 When the afflicted person does not receive understanding & validation for their issues & they may become even more prone toward stress, anxiety, despair & hopelessness.
In Fibromyalgia, a “spirit of fear” may trigger nerve impulses through the hypothalamus, which senses problems occurring in the spirit & soul. When the nerve impulse runs down the nerve into the dendrites & pulsates, it creates pain with nowhere to go. Many sufferers of fibromyalgia feel as though they have nowhere to go for relief. If you are struggling with fibromyalgia, keep an open mind to the healing power of God. Seek a Pastor or individual who is anointed with a gift for spiritual healing & deliverance & receive ministry for stress, anxiety & a spirit of fear.
Meditate on the following scriptures:

Be careful for nothing; but in everything by prayer & supplication with thanksgiving, let your requests be made known to God. Philippians 4:6
For God has not given us the spirit of fear, but of power, love & a sound mind. 2 Timothy 1:7

Sources:
American College of Sports Medicine. (2009). ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities (3 ed.). (J. L. Durstine, G. E. Moore, P. L. Painter, & S. O. Roberts, Eds.) Champaign, IL: Human Kinetics.
American College of Sports Medicine; National Center on Health, Physical Activity & Disability. (2012). ACSM/NCHPAD Resources for the Inclusive Fitness Trainer (Vol. 1). (E. F. Cary Wing, Ed.) Indianapolis, IN; Birmingham, AL: American College of Sports Medicine.
Phyllis A. Balch, C. (2006). Prescription for Natural Healing – 4th edition. New York, NY: The Penuin Group.
Wright, H. W. (2009). A More Excellent Way to Be in Health. New Kensington, PA: Whitaker House.
The Holy Bible: New King James Version