Q. I have been suffering from fibromyalgia for some years. I’ve been prescribed l0mg of amitriptylline at night to relax the muscles, which helps somewhat. I am also having acupuncture and take a cocktail of vitamins. I have tried many alternative therapies but am now looking for a way to manage this in the long term. I do not want to be taking medication for ever and would welcome any advice about diet, vitamins, lifestyle.
A. Fibromyalgia is a syndrome, rather than a disease with a definite cause, which means that it is a condition characterised by a collection of symptoms which may or may not be related. Fibromyalgia means literally pain (algia) in the fibres (fibro) of the muscles (myos). The pain occurs in distinct areas, unlike the generalised aching muscles that you find with, san flu, chronic fatigue syndrome or calcium deficiency.
Massage therapists call the sore lumpy spots on the muscles ‘knots’, which they unravel by pressing and rubbing. Usually there is one knot per group of muscles. Sometimes the pain spots are found in tendons and ligaments but these do not form knots as these tissues cant shrivel and roll up into a ball.
There are various pathways to fibromyalgia. Muscles that are repeatedly strained due to constant use (eg, during jogging, tennis, domestic chores) often get sore. This is primarily due to accumulation of a waste product called lactic acid. This occurs in the following way. Normally the energy you need to contract muscles is released when glucose burns with oxygen to product carbon dioxide and water in the muscles. But if the muscles overwork the oxygen supply from the heart and lungs cannot speed up enough to match the demand. The result is that the glucose is not fully oxidised and, together with the limited oxygen supply, forms lactic acid. It’s this that makes muscles cramp. You will have seen marathon runners brought to a halt because of this. After rest and massage, the oxygen supply is restored, the lumps and cramps disappear and the pain fades away.
Slow’ strenuous work, such as carrying, lifting or long hours at a computer can also be a culprit triggering prolonged accumulation of lactic acid and muscle spasm. Lactic acid also causes inflammation in these muscles. In defense, the body deposits fibrous tissue in the sore areas, to harden them so that the muscles can function again. Bug although the area is encased in scar tissue, the inflammation remains, and when the area is touched or moved, it hurts. When you’re resting however, with nothing pressing on the sore spots, there’s no pain.
People who do desk jobs, or have bad posture, usually have sore spots on top of the shoulder blades (on the trapezius muscle). Fibromyalgia also occurs wherever muscles are likely to suffer repetitive strain injury, including the buttocks, lower back calves, biceps, hands and wrists.
Conventional medicine focuses on managing the pain of fibromyalgia with painkillers, steroidal drugs and antidepressants. My approach is directed towards reducing the inflammation through diet and massaging with oil to ease the sore spots by improving blood flow to the area. Stress should be avoided because it often provokes insomnia and the pain threshold is then lowered.
These are my suggestions
* Good things to eat include turmeric, ginger, chicken broth and marrowbone soup.
* Avoid citrus or acidic fruit, including oranges, grapefruits, lemons, pineapples, kiwis, mangoes and excessive amounts of summer berries: they slow the healing of inflammation and the pain actually increases.
* Control stomach acid by avoiding hot, spicy and deep-fried foods, nuts, white wine, champagne, brandy, neat spirits, vinegar, canned products using citric acid as a preservative, and more than 500g vitamin C daily.
* It is important to avoid being constipated as it impairs calcium absorption in the colon: calcium deficiency can cause muscular spasm and subsequent pain. Drink one and a half to two liters of still, pure water daily, and, if constipation is a problem, take Qurs Mullayan: one at bedtime for two months.
* Ease inflammation with my formulation of herbal oils, Joint Oil. Find the sore spots and massage them with a little oil until it is absorbed. Do this daily for a month. lf you cant reach the area, ask a partner or friend to do it.
* Practise therapeutic Iyengar yoga, to stretch the muscles and relax you. The most useful postures for the spine, where the pain is usually located, are the cobra, semi bridge and boat. If you are practising at home, always remember to warm up first.