Fibromyalgia: an Integrative Approach

by Will Corell, M.D.

What is fibromyalgia? Many of our patients are painfully aware of the many symptoms of this syndrome, but does anyone truly know what it is, what causes it, or why we get it in the first place? I surely don?t, but I really wish I did. (For one thing, I would probably win the Nobel Prize!!) But, more importantly, I know I would be much better able to help the hundreds of patients I see with FMS if I knew the cause of their many symptoms. I?ve been trained since my early years in medicine to search for the causal factors of illnesses, and once these are identified, correctly treat the cause to cure the disease itself. For example, when I see a patient with a sore throat, the treatment depends on the cause. If it?s strep throat, penicillin is the treatment of choice. But if the symptoms are due to a cold, flu, virus, allergy, tumor, etc., an antibiotic will prove ineffective. So medical treatment, to be optimally effective, needs to be directed at the cause (or etiology) of the condition.

So, here we are at one of the primary problems in managing fibromyalgia ? we don?t know the cause of it! Current research is providing valuable information describing the physiological and biochemical abnormalities and imbalances present in this frustrating condition, but little is know about what causes these problems. We have some information about what kinds of band-aids to put on our ?owies,? but these treatments merely help to ease the symptoms, rather than heal the disease. Actually, I believe this is really the crux of the problem. I don?t believe fibromyalgia is a DISEASE per se. By definition, it is a syndrome or a description of symptoms, with no known etiology. Without an etiology, our treatments can be at best only the treatment of symptoms. We are told there is no cure for FMS, and I most humbly agree.

HOWEVER ? let?s look a little deeper. Are there other conditions that have been identified that cause symptoms similar to those of FMS that are treatable? I believe the answer to this question is YES, but we need help from our colleagues in natural medicine for further assistance. For century upon century, the naturalist has looked at the symptoms of the body as important clues regarding underlying imbalances in form and function, rather than an evil curse or affliction, to be suppressed by harsh drugs and pharmaceuticals at whatever cost. So, asking our bodies what they have to teach us may provide valuable insight to healing.

Learning to listen to our bodies may be one of the first steps along the path to health and wholeness. How do certain foods affect us? Are we more achy, tired or irritable after a certain food? (We may need to avoid them for a week or two first, then re-introduce them for symptoms to become apparent.) Is our body telling us it needs more of certain nutrients, insufficient in the standard American diet, in order to correct and re-balance our internal chemistry? Is our body responding to the multitude of toxic substances present in our external environment all around us, but also stored within the organs and tissues of each and every one of us living on our planet today? What is the status of our immune and endocrine systems, so ably designed to protect and defend us from unbalancing influences both inside and out? Why are so many patients with FMS low in DHEA and oxytocin, crucial hormones in helping to regulate our internal milieu? Surely replacing these key elements has helped many, many patients. But can we also search for the cause of their depletion, so we are not simply trying to fill up a bucket riddled with holes. Let?s try to learn how to patch the holes! What about stress as an unbalancing effect on our internal environment? Who knows the myriad of chemical endocrine and neurological pathways that are disturbed by our experience of stress, both emotional and physiological? Could stress be one of the primary mediators of the depletion of DHEA in our bodies? And what of the al- too-common symptoms of irritable bowel syndrome (again, another syndrome) that plague so many with FMS? Could our overall health and well-being have any relationship to the status of our bowel health, our ability to digest and absorb life-giving nutrients, while simultaneously processing and eliminating toxins and wastes from our body? Or, rephrasing all these questions: Does it not seem highly probably that any and all symptoms experienced in any one body are the sum total of all the complex and interdependent physiological and biochemical functions alluded to above?

These are the question asked in the practice of integrative medicine. We ask the wisdom of the body to help us understand the symptoms with which we are presented. To go beyond a simple listing and cataloguing of our various aches and pains, looking for a drug to suppress each symptom. But, to truly search for the causes behind the symptoms, to strive to learn from the body, identify and correct imbalances wherever possible, to realign our internal and external environments to be health-promoting rather than disease-producing, with the ultimate goal of assisting the body, mind and spirit to move toward balance, health and harmony.

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