One model of these conditions suggests that whatever the trigger (trauma, viral infection, toxicity etc) there need also to be perpetuating factors such as emotional stress, inadequate rest patterns, concurrent depression etc. The treatment approach suggested would tackle the behavioural and cognitive aspects, using agreed (between therapist and patient) targets for changing the behaviour pattern which has become established by the illness.

Careful planning and preparation are required with a lot of attention to engaging the patient in the process of recovery. The patient is not led to believe that this is all there is to treatment but is encouraged to see that while underlying factors (viral or yeast infection etc) are being dealt with the perpetuating factors can begin to be modified. A gradual increase in activity is the aim with equally gradual reduction in rest periods and time. The key to success is not to do too much too soon, staying within what is a manageable level for the patient. A structured schedule evolves via negotiation and discussion over 20 to 30 sessions. The same degree of activity is suggested on good and bad days, with perhaps no increase in activity initially but a structured pattern emerging. Very gradually activity increases and responsibility for what happens is transferred fully to the patient. Does it work ? Some claim it does but it takes dedication on everyone’s part.

Herbal Medicine⁷
There have been no clinical trials involving herbal treatment of Fibromyalgia however at least one very well researched herb is being used clinically to help circulation to the brain: Ginko biloba (see above).

In addition leading herbalists are on record as claiming benefits from an approach which tries to ‘support the nervous system with herbal nerve tonics and adaptogens’ (substances which help the body cope with stress). Additionally herbal methods try to help the defence mechanisms by using known immune system enhancers such as echinacea, astragalus and ginseng. Various nervine herbs would also be included in a combination aimed at helping normalise sleep disturbances.

A herbal combination formula is suggested which consists of:

• 2 parts Panax quinquefolium (American Ginseng)
• 2 parts Astragalus mongolicus
• 2 parts Angelica sinensis (Dong quai)
• 1 part Ginko biloba
• 1 part Cimicifuga racemosa (Black cohosh)
• 1/2 part passiflora incarnata (Passion flower)
• 1/2 part Betonica officinalis (Wood betony)
• 1/2 part Matricaria chamomila (Chamomile)
• 1/2 part Zizyphus sativa (Jujube red dates)

This formulation is claimed to be a tonic which will support people with chronic weakness, anxiety, headaches, sleep disturbances and general fatigue as well as diminished blood flow to the extremities. The person who needs this will probably have a weak pulse, weak digestive system, have headaches and will be fatigued. A dose of between half and one teaspoon (infusion) two or three times daily taken between meals is suggested.

Homeopathy^8,9
Several studies have looked at the effects of a specific homoeopathic remedy Rhus Tox in treating Fibromyalgia and ‘fibrositis’ with varying results.

Although treatment of painful rheumatic conditions by homeopathy often involves the use of Rhus tox it is therefore not suitable for all people with such conditions, but only those with the profile of the medicine.