Treatment ^14,15,16
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
EMG-Biofeedback ¹⁹
Hypnotherapy ²⁰
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:

1. 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.

2. 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.

3. It is important to assess and treat any associated conditions such as allergy, anxiety, hyperventilation, yeast or viral activity, bowel dysfunction, underactive thyroid, sleep disturbance.

4. 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.

5. 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

6. 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.

7. Appropriate osteopathic soft tissue treatment of the muscular condition, as well as regular (daily if possible) gentle self- treatment methods are usually helpful.

8. Regular exercise within tolerance, if possible including cardiovascular training and stretching movements (yoga and/or T’ai chi)

9. Medication under medical advice only, to enhance sleep patterns may be worth considering, antidepressant drugs in very low dosage commonly give some benefit.

10. 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.