Fibromyalgia – The Osteopathic Approach To Diagnosis and Treatment

Fibromyalgia is a syndrome characterized by pain in the muscles and fibrous connective tissues of the body.  It is categorized as a rheumatologic disorder of the fascial and muscular systems.  Quite simply, it is a wide spread disorder of muscular aches and pains.

Fibromyalgia also leaves one feeling totally drained of energy.   And for good reason - this fatigue is worsened by a pattern of sleep that is continually interrupted with awake-like brain activity.  As a result, one wakes up feeling exhausted instead of rested.

This syndrome has effects on the nervous system that can range from feeling anxious and having difficulty concentrating to developing disorders such as generalized anxiety and depression. 

The gastrointestinal system is affected in approximately 50% of these patients by non-specific patterns of nausea, diarrhea, abdominal pain, and/or gas.  Tension or migraine headaches affect 50% of these patients as well.  Other common symptoms one may experience include temporal-mandibular joint (TMJ) pain, chest pain, premenstrual syndrome, morning stiffness, and tingling and/or numbness.

Since there are no conclusive diagnostic laboratory or radiological studies at this time, the diagnosis of fibromyalgia is based on a physical exam and the patient’s medical history. The criteria for diagnosis are:  (1) symptoms similar to those described above (2) having pain in all four quadrants of the body for greater than three months and (3) a physical exam that reveals tenderness in at least 11 out of 18 specific points on the body.

Despite all the technological advances of modern medicine, the cause and disease process of fibromyalgia is not known; hence, conventional medical treatments are aimed at pain management.

Tylenol and non-steroidal anti-inflammatory medications such as Motrin and Naprosyn and newer COXII inhibitors such as Celebrex are the best medications at giving some temporary pain relief.  Narcotics, tranquilizers, and steroids are typically ineffective.  Tricyclic antidepressants and muscle relaxants may help improve sleep.  Seratonin selective receptor inhibitors (SSRI’s) such as Paxil, Prozac, Zoloft and Celexa are the most effective medications for treating depression and anxiety.

Unfortunately, medications typically give only temporary relief for this chronic condition.  Thus, patients are largely expected to treat themselves by modifying their lifestyle.  Partaking in regular low impact exercise such as water aerobics is recommended Patients who are having difficulty exercising due to their pain can benefit from physical therapy and therapeutic massage.  Additionally, meditation, visual imagery, progressive muscle relaxation, yoga, and biofeedback have been shown to help alleviate symptoms.  Another lifestyle change that often gets overlooked is the avoidance of caffeine and alcohol which both can exacerbate the condition.

What is the Osteopathic approach?

Osteopathy looks at each and every patient from a holistic structural perspective; one of its main premises is to acknowledge and support the inherent self- healing mechanisms of the body.  If the body is programmed to restore health to itself, what is blocking the intrinsic mechanism of health from doing its job?  That is our question and that is how the conversation begins between the patient’s inner reserve of health and the physician.  Thankfully, our anatomy and physiology, without exceptions, has answers.  Sometimes it stutters or shouts sharply; sometimes it speaks quietly but deeply. 

 By “listening with the hands”, it is the Osteopath’s job to discover both the source of dysfunction and its solution.  To do so one needs to look carefully.  As an example, the culprit dysfunction might be in the body’s continuous membranous system surrounding the bones, organs, muscle, nerves, and blood vessels.  Once identified, the body is brought into physical balance about this strain.   By doing so, the effects of this strain are no longer experienced by the body.  This leaves the health from within free to manifest corrective forces that create a healthier relationship between all the cells of the body. 

The body has an innate intelligence that surpasses even our vast supply of scientific study.  It has its priorities; it knows where to begin to unravel the tangle of a condition like fibromyalgia.  Like each individual, each case of fibromyalgia is unique and requires its own path to healthy resolution.  Osteopathic treatment is well suited to assist this.  It is the scope and mission of the osteopathic physician to know the body thoroughly – to sense in each individual body treated the exquisite subtleties between its various fluids, tissues, and physiological rhythms. The osteopath is able to discern health and treat dysfunction in these areas.  The good news for fibromyalgia is that it can respond to the facilitation of receptive and balancing hands. 

About Dr. Don Williams

Dr. Williams is board certified in Osteopathic manipulative treatment with the American Osteopathic Association and is a pain management specialist in the state of Washington.  His clinic is located in Spokane Valley and he provides treatment to patients from the Spokane, Spokane Valley, Post Falls and Coeur d'Alene areas.