Fibromyalgia is a condition with widespread debilitating pain. It is present in around 0.5-10% of the worldwide population with a seven times higher presence among females than males.

Apart from pain there are symptoms of fatigue, sleep disorders, stiffness, headaches, irritable bowel syndrome, memory or concentration problems etc.

The condition has no cure and most often patients continue to have symptoms throughout life.

There are several approaches to treating fibromyalgia. Apart from pain relievers and antidepressants that seem to ease symptoms are structured exercises that may help patients with fibromyalgia.

When are alternative therapies considered?

Alternative therapies are considered when the traditional approaches fail.

Some of these alternative therapies have been found to be beneficial in long term pain conditions like fibromyalgia. These include Mind-body therapies, Physical therapies and Biologicals or supplement based therapies.

Mind-body therapies

These include:-

• Cognitive behavioral therapy (CBT)
• Biofeedback
• Hypnotherapy
• Meditation
• Relaxation
• Imagery
• Music therapy

Of all these therapies the best evidence in fibromyalgia patients exists for biofeedback, hypnotherapy, and cognitive behavioral therapy.

Biofeedback or Electromyographic (EMG) biofeedback has been studied in patients with fibromyalgia. It leads to improvement in pain, stiffness and self efficacy. Exercise combined with biofeedback is more effective than either modality alone.

Hypnotherapy has also shown benefits in fibromyalgia patients in terms of improvement of pain scores, fatigue on wakening, sleep disturbance, discomfort scores etc. Hypnotherapy has also been explored in other chronic pain conditions.

Physical or manual therapies

These include:-

• Chiropractic
• Massage
• Acupuncture

Chiropractic is one of the most commonly used complementary therapies in fibromyalgia patients. Studies, however, fail to show definitive benefits of this intervention.

Some patients, however, may benefit by showing reduction of muscle stiffness and increase in range of motion.

Gentle massage but not deep-tissue massage has shown increased patient satisfaction. When compared to no treatment, gentle massage has shown greater relief of pain and depression and quality of life but no improvement in sleep problems.
 

Acupuncture has been found to be useful in fibromyalgia and has been endorsed by the National Institutes of Health (NIH) Consensus Panel on Acupuncture. The benefits, however, are more in acute pain rather than chronic pain.

Biologicals or supplement based therapies

These include:-

• Supplements
• Herbals
• Diet therapies

There are a variety of supplements that have been claimed to benefit patients with fibromyalgia. Some of these include:-

1. S-adenosylL-methionine (SAMe) (800 mg per day) for example has been found to be effective. It is an anti-inflammatory drug that also has pain relieving and antidepressant activities.
2. 5-hydroxytryptophan (5-HTP) (100mg thrice daily) which is a precursor to L-tryptophan and serotonin in brain can also help overcome sleep problems and depression. Serotonin levels may be improved by using 5-HTP either alone or in combination with St. John’s wort as per prescriptions of Naturopaths.
3. Studies have also shown slight or marginal benefits with magnesium replacements as supplements (200 mg twice or thrice daily).
4. Guaifenesin (600 mg twice daily) that reduces phosphate excretion.
5. Magnesium combined with malic acid (1200 mg twice daily). This may relieve pain, tenderness, and fatigue.
6. Some patients benefit from vitamin C (1000 mg thrice or four times daily) that raises immunity and reduces inflammation.
7. Coenzyme Q10 (50–100 mg twice or four times daily) may be taken to increase oxygenation of the tissues.
8. Chromium picolinate (200 mcg with meals).
9. Vitamin B complex may be taken as supplements to reduce stress.
10. Melatonin (0.5 to 3mg at bed time) may help in sleep.
11. Zinc supplements (30 mg per day) improves immunity.
12. Phosphatidyl choline and phosphatidylserine (300 mg per day) improves brain function.

Herbal therapies in use and being studied in fibromyalgia include:-

• Those that reduce stress and improve immunity include:-
  • Siberian ginseng (Eleutherococcus senticosus)
  • Schisandra berry (Schisandra chinensis)
  • Ashwagandha root (Withania somniferum)
  • Gotu kola (Centella asiatica)
  • Astragalus root(Astragalus membranaceus)
• For symptom relief some of the herbs in use include:-
  • Chlorella pyrenoidosa
  • Topical Capsaicin
  • St John’s wort

A vegan diet has been promoted in the treatment of fibromyalgia. This diet is free of animal products but high in raw foods such as nuts, grains, legumes, fruits, and vegetables.

Studies have tried to prove the superiority of this diet among patients with fibromyalgia. However, definite benefits are not seen.

Other alternative therapies

Other alternative therapies include electrotherapy treatments such as TENS, hydrogalvanic bath, and interferential currents. Homeopathy in addition may reduce pain and improve sleep.