Articles

Fibromyalgia

Related Health Condition

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Fibromyalgia

Introduction

Characteristically marked by chronic and extensive muscular and skeletal pain and stiffness, and often accompanied with fatigue, anxiety, sleep disorders, headache, bowel irritation, and arthrocele and articular numbness, fibromyalgia is a non-articular rheumatic syndrome and has distinct pressure pain points.

Wu believes that fibromyalgia is similar to the cold-type bi syndrome in traditional Chinese medicine. (1) Plain Questions, part of the Yellow Emperor's Cannon of Internal Medicine, the earliest medical classic extant in China (appearing more than 2000 years ago), wrote in its chapter on bi syndrome: "Wind, cold, and dampness meet it can cause bi syndrome. When the cold factor dominates, the pain-type bi syndrom results." Jiao thinks that judged by clinical manifestations, fibromyalgia falls into the pain and immobile-type bi syndrome categories in traditional Chinese medicine. (2)

Primary Treatments with Chinese Medicinal Herbs

Du Huo Ji Sheng Tang

Ingredients: Du Huo (Pubescent Angelica Root), Sang Ji Sheng (Loranthus), Du Zhong (Eucommia), Niu Xi (Achyranthes), Xi Xin (Wild Ginger), Qin Jiao (Gentian Root), Fu Ling (Hoelen), Rou Gui (Cinnamon Bark), Fang Feng (Siler), Chuan Xiong (Cnidium), Ren Shen (Ginseng), Gan Cao (Licorice), Dang Gui (Chinese Angelica Root), Bai Shao (Sheng) (White Peony), Sheng Di Huang (Rehmannia)

Function: One formula currently used to treat fibromyalgia is Du Huo Ji Sheng Tang. This is a classical formula that has been around since the 7th century and is considered to be an effective formula for treating fibromyalgia.

According to traditional Chinese medicine, this formula resolves rheumatism, alleviates arthralgia, tonifies the liver and the kidneys, and reinvigorates qi and blood. It is primarily used to treat arthralgia due to a deficiency in both the liver and the kidneys, and an insufficiency in qi and blood, which typically manifests in the following symptoms: cold and pain in the loins and knees, limited movement, soreness, weakness or numbness in the joints, preference for warmth and aversion to cold, pale tongue with white coating, and deep and feeble pulses.

Other Treatments with Chinese Medicinal Herbs

Combination of Ren Shen Yang Rong Tang and a Si Ni San modification

Lu believes that fibromyalgia is due to qi and blood deficiencies, stagnation of the liver-qi, and qi stagnation and blood stasis, and that any effective treatment should focus on invigorating qi and nourishing the blood, relieving the depressed liver and regulating the circulation of qi, and promoting blood circulation by removing blood stasis. For instance, he offers the following prescription combining Ren Shen Yang Rong Tang and a Si Ni San modification: Huang Qi, Dang Shen, Bai Shu, Fu Ling, Chai Hu, Bai Shao, Zhi Qiao, Dang Gui, Chi Shao, Dan Shen, Da Zao, Mai Ya, Long Chi, etc. (3)

Combination of Yang Xin Tang and a Ge Gen Tang modification

Cai has treated 42 cases of fibromyalgia with the combination of Yang Xin Tang and a Ge Gen Tang modification. The prescription is as follows: Bai Zi Ren, Suan Zao Ren, Fu Ling, Zhi Gan Cao, Wu Wei Zi, Dang Gui, Ge Gen, Bai Shao, Gui Zhi, Gan Jiang, Xi Xin, and Da Zao. Cai reports that of the 42 cases treated, 29 (69%) have significantly improved, 11 (26.2%) have improved, and 2 (4.8%) with no response to the treatment. (4)

Chai Hu Du Huo Tang

Shen has treated 53 cases of lumbar fibrositis with Chai Hu Du Huo Tang. The prescription is as follows: Chai Hu, Cang Zhu, Fang Feng, Du Huo, Chuan Xiong, Qing Pi, Zhi Gan Cao, Zhi Chuan Cao Wu, and Xi Xin. Shen reports that of the 53 cases treated, 37 have been resolved, 6 have significantly improved, another 6 have improved, tallying an overall effective rate of 92.5%. (5)

External Applications

Lin has treated cervical, shoulder, and back fibrositis with external applications. The prescription consists of the following ingredients in equal quantities: Dang Gui, Du Huo, Qin Jiao, Wei Ling Xian, Wu Jia Pi, Fang Feng, Cang Zhu, and Ma Qian Zi, plus Chuan Wu in double quantity. Grind and mix the ingredients well. Take an appropriate amount of the mixture and add water to make a paste of it. Indirectly heat the paste to about 45 degrees Celsius, wrap the paste in gauze and place the wrapped paste in the affected cervical, shoulder and back area. Each treatment cycle calls for applying the paste for 30 minutes daily for 10 days. Criteria for evaluating treatment effects: Pain and fiber-like substance disappear, and free cervical and shoulder movement; significant improvement: pain mostly disappears, pressure pain significantly lessened, band- and fiber-like growth shrunk and softened, and almost normal shoulder movement; improvement: pain and pressure pain lessened, band- and fiber-like growth shrunk and softened, and improved cervical and shoulder movement; no response: no apparent change in symptoms and physical signs. Lin reports that, of all the cases studied, 273 (83.74%) have been resolved, 33 (10.12%) have significantly improved, 19 (5.83%) have improved, and only 1 (0.31%) with no response. (6)

Tao has combined pain point injection and external application to treat fibrositis. Treatment: injecting vitamin B1 at appropriate acupoints, and then apply externally to the 3-5cm area around the needle point a honey-mediated paste made of the following ingredients: Zi Jing Pi, Du Huo, Chi Shao, Sheng Nan Xing, Chuan Wu, Xi Xin, Bai Zhi, Shan Nai, Bai Zhu, and Rou Gui; the bacteria-free paste is to be covered with a piece of adhesive cloth and stay in place for three days. Tao has reported satisfactory results from the treatment. (7)

Other Treatments

Thread Burial Therapy
Zhang has treated muscular fibrositis by pressure pain point thread burial therapy. Method: locate the most obvious pressure pain point, observe the sterilization routine, achieve anesthesia by 2% procaine hydrochloride, and bury #1-3 surgical catgut under the acupoint. Cover the needle point with a cotton ball for two days after each burial. Each burial session treats 1-3 acupoints, and lasts 30 days. Generally, the patient has significantly improved after three sessions. (8)

Mineral Spring Bath
Chen has treated 53 cases of fibrositis by mineral spring bath, and reported 27 cases significantly improved, 21 improved, 5 with no response, tallying an overall effective rate of 90.6%. (9)

Musico-electrotherapy
Zhang has used musico-electrotherapy to treat fibromyalgia. The treatment uses melodic tunes of optimum tempo and force individually picked to match the patient's condition, mood, and music appreciation level. With the therapeutic electrodes placed in the neck and waist areas, the patient lies down, puts on a headset, relaxes and enjoys the music. The volume and current outputs are adjusted to achieve the maximum results. The treatment is administered for 30 minutes once daily, and one treatment cycle lasts 15 days. (10)

Acupunture & Acupressure

Acupuncture, massage, and cupping
Huang, et al. have combined massage and bloodletting puncturing and cupping to treat 82 cases of scapular levator muscular fibrositis, and reported that 62 cases have diminished, 10 cases have significantly improved, 8 cases have improved, and 2 cases with no response, tallying an overall effective rate of 97.6%. (11)

Liang has combined cupping and acupuncture with moxibustion-warmed needles to treat 42 cases of muscular fibrositis, and reported satisfactory results. (12)

Yang has combined cupping and external application to treat 133 cases of fibrositis, and reported 86 cases have diminished, 26 significantly improved, 16 improved, and 5 with no response, tallying an overall effective rate of 91.1%. (13)

Zhu has combined hegu (LI 4) point stimulation and slow motion needling to treat 50 cases of lumbar and back fascial fibrositis, and reported 39 (78%) cases have diminished, 8 (16%) significantly improved, and 3 (6%) improved. (14)

Wu has used the traditional point prescription acupuncture and the Western "trigger point" acupuncture, respectively, to treat 32 cases of fibromyalgia syndrome, and reported a 97% overall effective rate for the point prescription group, and a 91% overall effective rate for the "trigger point" group. (15)

Ren has used the day-prescription method of acupuncture (far-infrared radiation or cupping was also used in some cases) to treat 51 cases of fibrositis, and reported good results. (16)

Cui has used cupping to treat 1230 cases of muscular fascial fibrositis and reported satisfactory results. Method: locate the trigger point in the affected area, and treat it by plum-blossom needling and flash-fire cupping; after cupping, apply externally an author-prepared plaster (to promote blood circulation and relieve pain) or a dog-skin plaster (by Tongren Hall of Beijing) for three to five days (one treatment cycle calls for the use of two plasters). (17)

References

  1. Wu Qing Lin, et al. Sichuan Journal of Traditional Chinese Medicine. 1997;15(4):8.
  2. Jiao Shu De. Journal of Traditional Chinese Medicine. 1988;30(4):4.
  3. Lu Xi. Fujian Journal of Traditional Chinese Medicine. 1988;19(5):56.
  4. Cai Tie Yong. Journal of Combing TCM and Western Medicine. 1992;12(4):247-248.
  5. Shen Zu Fa. Sichuan Journal of Traditional Chinese Medicine. 1991;9(4):31.
  6. Lin Zhong Hao, et al. Fujian Journal of Traditional Chinese Medicine. 1997;19(4):57-58.
  7. Tao Chun Hui. Jilin Journal of Chinese Medicine. 1998;18(2):30.
  8. Zhang Zhen. Sichuan Journal of Traditional Chinese Medicine. 1991;9(9):48.
  9. Chen Chu. Journal of Chinese Physical Therapy. 1991;(2):100-101.
  10. Zhang Han Qing, et al. Journal of Combining TCM and Western Medicine to Treat Rheumatic Diseases. 1997;6(4):254-255.
  11. Huang Ji Yan, et al. Massage and Induction. 1996;10(4):4-5.
  12. Liang Qing. Journal of Practical TCM Internal Medicine. 1999;13(3):49.
  13. Yang Jian Min, et al. Anhui Journal of TCM Clinical Application. 1996;8(3):130.
  14. Zhu Shi Tao, et al. Journal of Acupuncture Clinical Application. 1996;12(12):41.
  15. Wu Tao. Shanghai Journal of Acupuncture. 1998;17(4):19-20.
  16. Ren Tian Ming. Journal of Acupuncture Clinical Application. 1995;11(1):12.
  17. Cui Wen Ping. Chinese Folk Medicine. 1998;(1):13.