Treatment Options For Fibromyalgia

Consider A Real Case

The young wife and her husband were waiting anxiously in the exam room,  ” What seems to be troubling you Stella…”,  I asked her?   “I am so uncomfortable Doctor.  I ache all over, I have trouble sleeping, I have no energy, and I am depressed,” she said with a frustrated tone of voice.

“I have been to several other primary care physicians who all refer me to a psychiatrist.  I am not crazy. I was fine just a few months ago (her husband rolls his eyes) and now I feel like I need to go on disability.” I looked at Stella’s husband, who said,  “Doc, we haven’t had sex in months…you have got to do something” (quite a sensitive guy,eh?).

If this sounds familiar then your have become acquainted with a common contemporary syndrome called Fibromyalgia.

What Is Fibromyalgia?

Fibromyalgia (FM) is a disorder characterized by widespread musculo-skeletal pain, associated with fatigue.  It also is characterized by sleep disturbances, memory deficits, mood issues and an assortment of other symptoms.

Although Fibromyalgia (FM) has probably been around  since the early 1820’s (called muscular rheumatism at that time), the syndrome was officially recognized in 1990 by the American College of Rheumatology and guidelines for diagnosis were created.  Those guidelines were published in an attempt to increase the accuracy of diagnosis for this very uncomfortable disorder.

FM occurs 7 times more frequently in women than men and tends to cluster in families.  There is an association with depression.  But what actually causes the symptoms?

american college of rheumatology fibromyalgia 2010

What Causes Fibromyalgia?

The exact cause of Fibromyalgia is unknown. The location where the abnormality originates is thought to be  in the central nervous system.   This causes the diffuse symptoms in FM and explains its association with other psychological disorders (depression for one).

Dr. Mohammed Yunus, MD has suggested that FM belongs in the category of a syndrome he calls the “Dysregulation Spectrum Syndrome” (DSS). Essentially, DSS is a disruption of the chemical transmitters in the brain with resultant effect on hormones and nervous function.  As the nervous system is connected to every part of the human body, the symptoms in FM are widespread and variable.

cause of fibromyalgia

What Are The Symptoms Of Fibromyalgia?

The symptoms of FM are diffuse muscle pain with other systemic symptoms.  The image below gives a fairly good review of most of the symptoms that can occur with FM:

symptoms of fibromyalgia

How Is Fibromyalgia Diagnosed?

The essential components for the work-up of FM are as follows:

American College of Rheumatology

There is no definitive diagnostic study that tests for FM.  FM is what is called a “diagnosis of exclusion.” What that means is other diseases that could give the same symptoms must be excluded before a diagnosis of FM is made.  The criteria for the diagnosis of FM is as follows:

diagnostic criteria for fibromyalgia

By totaling up the score for widespread pain and symptoms severity, the diagnosis of FM is established.

Are There Any Therapies That Will Actually Work?


The treatment of FM is non-specific and directed at symptom relief.  There is no specific treatment that seems to reverse the disease process.

If you look at the treatments through a “conceptual lens” it would seem that nearly all effective treatments can be seen to effect the neurotransmitter levels in the human brain. Exercise, massage therapy, diet therapy, and nutraceutical supplements are all aimed at up-regulating neuro-transmitters.

For a more detailed discussion on Cymbalta just click on the topic to be linked to it.

A promising form of treatment (being administered under a doctor’s care exclusively) is as structured by Dr. Hinz. His method utilizes a high dose supplement which restores the neurotransmitter balance in the brain.

I do want to emphasize that this form of care for FM must be directed by a licensed physician. According to an article written by Dr. Stevan Cordas, the results that Dr. Hinz has had with his regimen have been consistently positive. This is in contrast to the mixed results that most other therapies yield.

A wide range of therapies are also used in the treatment of FM. The following depicts what is often used:


A person suffering with this malady must persist in trying multiple different therapies to finally discover what works for them.

As can be imagined, it is really difficult to search and try multiple different treatments while feeling so uncomfortable. I have observed that those who do so will eventually discover a regimen that works for them. The key factor is to not give up!

If you have any questions, please leave them below. I would love to be of service to you.
Wishing you joy and healing,

Dr. Jeffrey Bado, D.O.

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