Fibromyalgia

Fibromyalgia (FMS) can respond extremely well to homeo­pathy - by Dr Angela Jones

Fibromyalgia syndrome (FMS) is a common rheumatological condition  characterised by chronic widespread pain and ten­derness at specifically  defined points. Painful stimuli are often felt very  intensely(hyperalgesia) and non-painful stimuli, such as brushing, can  also be felt as pain (allodynia). People with FMS often have other  problems, including fatigue, depression, anxiety, sleep dis­turbance,  headache, migraine, variable bowel habits and diffuse abdominal pain  (irritable bowel syndrome) and urinary frequency. It is also said to be  found more frequently in patients diagnosed with rheumatoid arthritis  and systemic lupus erythematosus (SLE).

What causes FMS?

The cause of FMS is not known. It is likely that different people  diagnosed with FMS are actually suffering from the symptoms for  different reasons and some of the suggestions include hyper-excitability  of the central nervous system and alterations in the mechanisms for the  perception of pain as well as inter­actions with the limbic system  which governs sleep, and stress and immune regulating systems.

How common is FMS? 

Estimates of how many people suffer from FMS vary. A US population  study in 2006 based on health insurance data suggested one in 72 people  was affected with a 62/38 split female to male. This is interesting as  previous surveys suggested a much higher incidence in women but it could  be that men suffer­ing from the disease are more likely to attract a  diagnostic label and treatment within the US health system.

Homeopathy & FMS 

Every patient with FMS has their own story, their own  constellation of symptoms, their own trigger factors, their own way of  coping with the illness. In this kind of situation, the homeo­pathic  approach comes into its own, allowing for the individualisation of a  remedy or medicine to match the fea­tures displayed by the patient. As with most homeopathic treat­ment, the medicine may be chosen on  the basis of the symptoms of the illness, or on the characteristics of  the patient as a whole (constitutional prescribing), or both. Dr Tom  Whitmarsh demon­strates a range of approaches in the case studies  described later. What is clear is that, as always with homeopathy, the  medicine must be individualised to the patient and the case in order to  be suc­cessful.These are a few local remedies, which could be considered for people  with FMS but be aware that they can only be expected to be helpful if  the symptoms match those of the patient well.

Rhus tox: this is the rheumatism remedy par excellence and was  the rem­edy studied by Dr Peter Fisher in the 1980s and shown to be  effective in a double blind placebo-controlled trial of fibromyalgia. It  is effective for pain and stiffness which is worse when having been  still and gets better for getting moving, particularly bad after  overdo­ing things or in cold damp weather, eased by warmth and moderate  exercise. It is interesting to note how these match up with the  conventional recommendations below!

Ruta grav: the remedy picture is sim­ilar to Rhus tox except  that the stiffness is, if anything, more marked and less susceptible to  improvement with gentle movement. There is often involvement of the  tendons or the places where ten­dons meet bone (heels, elbows etc).  There is often a bruised feeling. Pains are worse for cold damp weather  but without the definite benefit from warmth which is seen in Rhus tox.

Rhododendron: the picture is very similar to Rhus tox except  that the pains are very much worse for changes in the weather,  especially if there is an impend­ing storm or thunderstorm.

Arnica: this medicine is best known for its action on injuries  to reduce bruis­ing and swelling. However, it is useful whenever the  body feels bruised and sore, especially if markedly worse after  exertion. A characteristic feeling des­cribed is of “the bed feeling too  hard”, in other words, soreness and bruised feeling is worse if the  part is lain upon. Arnica can be a good medicine to start treatment of  fibromyalgia with, if there is not a clear picture suggesting another  medicine at the onset. Hopefully, after a period, a clearer picture will  develop.

Causticum: again, soreness, weak­ness and stiffness, worse  with exertion and cold, better for warm applications and being warm in  bed. The unusual thing that might suggest Causticum is that the symptoms  are worse in dry weather and better when it rains!

Bryonia: for Bryonia to work, the pain must be very much worse  for the slightest movement (the opposite of Rhus tox). Heat will  aggravate the pain and pressure on the relevant part alle­viates,  possibly by preventing move­ment. In my experience, this is a more  unusual presentation for fibromyalgia.

Kalmia latifolia:
this medicine is especially helpful for severe  shooting pains in muscles, and there is often an accompanying numbness  or cold sen­sation. Always make sure that there is no suggestion of  nerve pressure or dam­age, if these symptoms are present. 

Cimicifuga: this medicine is used where the pains, soreness  and stiffness are mostly in the neck and upper back muscles. These may  have been preceded by an injury and are generally worse for cold or  drafts. Symptoms are often accompanied by headaches, especially on the  top of the head or radiating up from the neck.

Dr Tom Whitmarsh describes two cases of fibromyalgia 

In my experience at Glasgow Homeo­pathic Hospital, it is unusual to find  someone with symptoms of fibromyal­gia just on its own. Most people  affected are struggling with multiple diagnoses and so many things feel  wrong in addi­tion to the pure symptoms attributable to fibromyalgia.I quite often find myself giving more than one medicine, often  addressing the constitution with one remedy and the pain with another,  perhaps in a lower potency.

Fay's story 

Fay is 64. She has described herself as a “career woman”, working  for and event­ually running various companies and always active and  engaged fully with life. She first sought homeopathic help when she was  54. She had had pain in the chest fully investigated conven­tionally and  little was found, though she had had lifelong heartburn. She had had a  lot of anti-acid medications for this and was eventually found to have  gallstones for which she had her gall­bladder removed.She suffered from recurrent attacks of bronchitis and to crown it  all, fell down some steps on the way to her gar­den and sustained a  crushing of one of her spinal vertebrae at the age of 52. She was  subsequently found to have general thinning of the bones (osteoporosis).  Soon after the fracture of the spine and the discovery of osteoporosis,  she began to suffer from widespread aches and pain in her muscles. She  saw a rheuma­tologist, who did lots of tests (mostly negative) and  confirmed a diagnosis of “secondary fibromyalgia”.A highly communicative woman, Fay suffers a constant feeling of heat  throughout the body and notices how easily she comes out in bruises at  the slightest knock. She described her expe­rience of the pain – “it  feels as if the body is on fire”, or the pain can be sharp and stabbing.  It is particularly bad when she tries to use her arms. The example she  gave was how uncomfortable it is to stand and chop vegetables. “It is a  pain I cannot bear.” If sitting down and the pain gets bad, then she can  find herself sliding down the chair, which gives a small measure of  relief. She hates to be constricted with any tight clothing and very  much prefers loose things to wear.She had become miserable and depressed at her inability to cope with  the pain brought on by the normal tasks of living – she had been so fit  and active. She was helped with pain in her ankles, knees, lower back,  shoulders and wrists initially by addressing the vertebral frac­ture  with a high potency (200c) of Arnica and also Arnica cream to rub into  the back. The remedy which has been most helpful for her generally has  been Lachesis, in high potency, 200c three doses over 24 hours, and then  LM1 five drops daily. This she says, “lifts the mood” and “helps a lot  to let me cope”. The particular muscle pain all over the body was helped  with regular doses of Rhus tox 6c three times a day.

Patricia's story

Patricia is 45. She was referred for in­patient care by her  rheumatologist, who had performed many tests and made diagnoses of  depression and fibromyal­gia. It was noted in the referral that she was  undergoing some marital dishar­mony. Her husband had affairs while she  was unwell and suffering from panic attacks, as well as a very reduced  libido. They went to Relate for counselling together, but she remained  worried that it might happen again and she had lost her trust in her  husband. She is quite fas­tidious about the state of her home and one of  her big upsets is that because of the pain in the muscles, she is no  longer able to be as tidy as she wants to be in her house. She has two children who are well and a grandson whom she adores. She  describes them all as being “very much part of my life” and she gives  the air of being a welcoming mother to them all. Every detail of their  lives concerns her.She has pain in all her muscles from the neck down, which she  describes as “like someone inside, twisting my mus­cles and joints”.  There’s also an “excru­ciating nerve pain”, like a dentist hitting  something with a drill, in the muscles most days. The pain is worse with  any activity. It is exhausting and she suffers “horrible fatigue” by  the end of every day. She has frequent dreams of her childhood family  home and her parents. She was scared to leave her husband, although he continued to have  affairs and was unsupportive of her illness as she was scared of  “splitting the family up”. She was admitted to Glasgow Homeopathic  Hospital and given the remedy Calc carb 200c, three doses over 24 hours  and the LM1 five drops daily. The next time we saw her, three months  later, she had made definite plans to leave her husband and was feeling a  lot calmer because of this decision. The pain was unchanged. The  potency of the rem­edy was increased to LM2 and the pain has begun to  come under control. She still plans to leave as well. Calc carb is often given to people who invest a lot of their energy  in home­making and making the home beautiful for their family. One can  see what a des­perate betrayal the husband’s serial infi­delity is for  such a person and why it might make them particularly unwell. So in this  case, the constitutional rem­edy was all that has been required.

Dr Angela Jones is an NHS GP with a  private homeo­pathic practice in Cardiff. Tom Whitmarsh MA MBBS FRCP FFHom is Consultant Physician in Glasgow.