Manual therapy, nutrition, stress reduction, breathing and
postural reeducation, exercise (in some cases), acupuncture,
non-specific immune system modulation such as hydrotherapy ,
medication (herbal, homeopathic and standard), among other
things, have all been useful in encouraging recovery.
Goldenberg has shown that the following methods all produce
benefits in treatment of FMS.: 17
Cardiovascular Fitness Training 18
Regional Sympathetic Blockade 21
Cognitive Behavioural Therapy 22
My Own Protocol
Where a condition has multiple interacting causes it makes
clinical sense to try to reduce the burden of whatever factors
are imposing themselves on the defence, immune and repair
mechanisms of the body, while at the same time doing all that is
possible to enhance those mechanisms.
In my own practice the following are the methods suggested and
used in treatment of FMS not necessarly in the order listed:
- It is vital to get the diagnosis right. Many other rheumatic-
type problems can produce widespread muscular pain such as
polymyalgia rheumatica. Laboratory and other medical tests can
identify most conditions which are not FMS.
- Where muscle pain exists it is necessary to discover how much
of the problem might be related to myofascial trigger point
activity since the pain from trigger points is relatively easy
to eliminate using methods chosen from injections, acupuncture,
bodywork and postural and/or breathing reeducation.
- It is important to assess and treat any associated conditions
such as allergy, anxiety, hyperventilation, yeast or viral
activity, bowel dysfunction, underactive thyroid, sleep
- It is useful to introduce constitutional health enhancement
methods such as breathing retraining, deep relaxation methods
(e.g. autogenic training ) regular (weekly or fortnightly)
detoxification (fasting) days (which boost growth hormone
production), hydrotherapy (neutral bath for anxiety and possibly
progressive cold bathing), regular non-specific massage and
acupuncture for ‘energy balancing’ and pain control.
- Provision of suitable nutritional advice in important as well
as use of supplements if necessary, such as specific amino acid
supplementation for stimulating growth hormone production
- Specific herbal help for circulation to the brain [e.g. Ginko
biloba] and the taking of homoeopathic remedies such as Rhus tox
6C may be useful.
- Appropriate osteopathic soft tissue treatment of the muscular
condition, as well as regular (daily if possible) gentle self-
treatment methods are usually helpful.
- Regular exercise within tolerance, if possible including
cardiovascular training and stretching movements (yoga and/or
- Medication under medical advice only, to enhance sleep
patterns may be worth considering, antidepressant drugs in very
low dosage commonly give some benefit.
- Patients should be encouraged to join support groups, and
to read about their condition and health enhancement, and to
take control of their condition, even if progress is apparently
slow. Stress or general counselling may help them learn coping
skills and stress reduction tactics.
1. Sydney Block Fibromyalgia and the Rheumatisms Controversies in Rheumatology