FIBROMYALGIA
"CHRONIC FATIGUE"

Fibromyalgia is a condition characterized by achy muscle pain that has no obvious physical cause. The painful muscles are usually found in the shoulders, neck, chest, back, hips and knees although any muscle may be involved. The condition is more common in women. Symptoms usually start between 20 and 40 years of age.

Etiology:
The disease was described in 1843 and labeled "Fibrositis" which implied an inflammatory process. Subsequently muscle biopsy show no inflammation and the term "Fibromyalgia" has been in common usage for about 17 years.

Symptoms:
Patients present with, insomnia, non-restorative sleep and generalized pain. Other common symptoms include: irritability, nervousness, impaired memory and concentration; headaches, dizziness, blurring of vision, eye irritation, sensations of heat and flushing or actual sweating; unexplained anxieties; sugar craving; nasal congestion, post nasal drip; abnormal tastes, ringing in the ears; numbness and tingling anywhere (more usually of the hands and feet); gas and bloating, constipation alternating with diarrhea (irritable bowel syndrome); symptoms of bladder or vaginal infection. Trigger points are seen in most patients. Patients complain of pain and dysfunction specific to the affected muscle:

Treatment:
Treatment includes: relief of pain (Tylenol, Advil, Darvocet-N); antidepressants; injection of local anesthetic with or without steroids into the tender points and trigger points; exercise stretch and intermittent cold therapy. Dr. St. Amond recommends the use of Guaifenesin, which is available in a 600 mg. tablets, and reducing intake of aspirin and reduce the use of all salicylic acid products to zero.

The following is a partial guide to natural and synthetic salicylates that must be avoided:

Medications:

	Pain products labeled salicylate or salicylic acid such as aspirin, Salsalate, Disalcid, Anacin, and Excedrin.
	Herbal medications such as ginseng, St. John’s wort, gingko biloba, saw palmetto, blue-green algae Echinacea, or nonni juice; vitamin supplements with alfalfa, parsley and E or C if derived from rose Hips or with bioflavonoids.
	Lozenges with menthol, mint, peppermint or spearmint (4) Wart or callus removers (sal-acid plasters) and many acne products and dandruff shampoos.
	Pain creams, balms and lotions such as Ben Gay, Myoflex, Zostrix (Capsaicin or capsicum).
	Medications such as Alka Seltzer or Urised.

Detailed list of salicylic free products can be found at: http://www.guaidoc.com/salfree.htm

Diet:
There are no diet restrictions, unless you also have hypoglycemia. Many fibromyalgic patients, especially women, are carbohydrate intolerant ("Hypoglycemic") and must restrict intake of sugar and starches.
Hypoglycemia diet: 
http://www.guaidoc.com/Research_HGdiet.htm

Activity:
Exercise as tolerated with focus on stretching the evolved muscles; usually low impact exercise such as water therapy and Walking. 

Alternative Approaches:
Some patients find biofeedback beneficial as well as yoga, tai chi, stress management and acupuncture.

Reference:
R. Paul St. Amand, M.D.
Assistant Clinical Professor of Medicine
Harbor, UCLA

Some of the information in this article is used with permission from Dr. Amand. 
Please be sure to visit his very informative web site at: http://www.guaidoc.com.

Dr. Amand’s link pages to other helpful information about Guaifenesin and fibromyalgia:
http://www.guaidoc.com/resources-links.htm