Creating Happy, Pain-Free and Functional Fibromyalgia Patients

Townsend Letter for Doctors and Patients,  Nov, 2001  by William Wong

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In this brief piece I would like to outline the most successful treatment plan for Fibromyalgia to date. Having seen FMS treated here in the states, and spoken to leading researchers in Germany on FMS, as well as hundreds and hundreds of Fibromyalgia patients, I have not seen any treatment protocol work as well as this one to restore full function, strength and mostly pain-free range of motion. It is so rare for FMS patients to be virtually pain and fatigue-free that I believe it is a moral imperative that this multi-dimensional approach and its rationale be shared with the rest of the health care community.

My work with Fibromyalgia began in the late 80's when part of a multidisciplinary practice that included, an allopathic anesthesiologist, a GP, a chiropractor, a naturopath (me), exercise physiologist (also me), massage therapists, Rolfers, physical therapists, hands-on energy therapists, Trager therapists, and microcurrent electrotherapy specialists (here again, me). Whatever might have some chance of working -- whether we could develop a rationale for its use or not we tried. If it worked, it was kept -- if it did not it was discarded.

In 1990 I became a CFS patient myself and then my search began in earnest for something to make getting through the workday easier. The breakthrough came with a realization as to:

1) The source of pain in FMS and

2) The source of fatigue.

After these two light bulbs lit, treatment plans devised to address the issues involved. The performance and application of these plans is not easy and they are not without some discomfort, but for those FMS patients who truly seek to get better the treatment will work.

Realization #1) Where does the Fibro in Fibromyalgia come from and what does it do? This is the least looked at question in FMS! Okay, we call the syndrome Fibrotic Muscle Pain syndrome. Have we ever addressed the fibrin component of this condition? We've danced around it acknowledging that the masses of fibrin do appear on contractile tissue, we squeeze them, manipulate them, attempt to Rolf them and basically tear or realign them, but why are they there? What physiological condition precipitated their existence? And more importantly, can that condition he reversed and in turn reduce the fibrotic component?

Why am I concentrating so much on the fibrotic aspect of this condition? It's what causes the pain and what causes the pain meds to not work! Most of us have been baffled as to why the strongest of pain medications don't seem to scratch the surface of the unrelenting FMS pain. This leads many in the allopathic community to think that the pain is strictly psychosomatic. Fibrotic over-deposition on contractile tissue binds down that tissue, causing a localized ischemia. Just as the ischemic pain from an MI (Myocardial Infarction or heart attack) cannot be dealt with by applying pain medication; the pain meds do nothing to relieve the ischemia caused pain in FMS patients! To relieve the pain of ischemia ATP production in the affected tissues must be increased to provide for anaerobic respiration of the cells during the period of oxygen depletion. Then things must be done to increase oxygen levels so that full aerobic respiration of the cells is restored.

But first, why is fibrin there in the first place? While Max Wolf, MD, PhD was teaching at Fordham and researching at Columbia he came to an interesting discovery most of us are only partially familiar with. This author of the first medical textbook on endocrinology found that old age begins at 27 (most of us learned that in physio). This is triggered by a downturn in the body's production of proteolytic enzymes. Aside from their familiar but secondary roles in digestion, proteolytic enzymes have four primary functions in mammals:

1) First line of defense against inflammation. Enzymes cleave Circulating Immune Complexes it sees as being excessive in number or exogenous to the body.

2) Balances the body's repair mechanism, preventing excessive fibrin from being deposited in wounds, fractures and across joints or moving parts.

3) Cleans the blood of necrotic debris and excesses of fibrin.

4) Modulates immune function as an adaptogen. [1]

In the US the notion still exists that enzymes are too large a protein to be absorbed whole. Both studies and clinical experience in Europe over the last 40 years show that they are absorbed well. [2] We have no trouble believing that salmonella can be absorbed whole and salmonella is 5 times larger then the largest enzyme!

Women (who comprise 60% or more of FMS patients), seem to suffer more from fibrotic conditions than men do. This can be due to estrogen dominance. Estrogen is a known fibrinogenic and has been found to be the spark that induces fibrotic conditions of the breast, ovaries and uterus. These days everyone -- male and female -- seems to be estrogen-dominant. Estrogen "pollution" from farm and industrial chemicals, insecticides and petroleum fumes mark the greatest contributors. Also, more and more people are increasing their estrogen load by consuming soy with its isoflavones, which strengthen the effect of the body's own estradiol. [3-5] Both oral supplements and topical creams of natural Mexican yam progesterone are used to reduce estrogen dominance.