Understanding and Treating Fibromyalgia From An Acupuncture Perspective

Fibromyalgia can be a difficult disease both to identify and to treat from the western medical perspective.  Literally every single fibromyalgia patient I’ve ever seen had gone for months, sometimes years before being diagnosed.  It is sadly not too uncommon that more than a few have even been told by their respective MD’s that ‘it’s all in their heads’.  Many of them were put on medications that did nothing for their pain and more often than not had mild to moderate unpleasant side effects.  Most of the time my patients with fibromyalgia have already tried every western treatment with little to no positive benefit and we’re basically their last resort.  Which is really unfortunate as acupuncture is particularly effective at treating fibromyalgia.

There are a few different underlying TCM (Traditional Chinese Medicine) patterns that are usually involved with fibromyalgia.  From a TCM perspective the most commonly seen are qi and blood deficiency and/or stagnation and liver qi stagnation (0), others are listed on our acupuncture for fibromyalgia page).  In my own clinical experience I almost always see some issues with the heart system as well, which is just a more specific description of where the qi/blood stagnation and deficiency is manifesting.  In a nutshell, what all that means is the natural flow of the qi (energy) and blood is impaired, often due to a weakening of the energy to keep everything moving in the first place.  Pain is the result of stagnation (of energy/blood/fluids) and therefore when there is both qi and blood stagnation there is almost certainly going to be pain.  An underlying deficiency of the qi/blood is usually seen in chronic cases and simply reflects a weakened state that results from chronic imbalance.  The liver qi stagnation often translates symptomatically into stress, depression and anxiety that are exacerbated by chronic pain and discomfort.  It is important to note though that with fibromyalgia, like all western diseases, the underlying TCM patterns that give rise to the symptoms may be very different across individuals.

Acupuncture is a safe, natural, and most importantly effective method for treating fibromyalgia and there are clinical studies that confirm that (1,2,3).  In my clinical experience most patients are able to notice at least a moderate and often more significant reduction of the pain and discomfort within a few treatments.  Perhaps more importantly the vast majority of patients notice a significant improvement in overall quality of life.  Much of the emotional turmoil that they experience due to the constant pain, difficulty diagnosing and treating the disease, etc. can be significantly resolved with acupuncture (4,5).

In Chinese medicine the emotions are considered an integral part of the body’s energetic physiology.  In a nutshell, emotions can directly influence the physical body, and vice-versa.  That concept has yet to gain full traction in the practice of western medicine, particularly in a clinical setting where there is evidence that the empathy of doctors is actually declining (6).  There is however a growing body of western research regarding the relationship between the emotions and various physiological markers which essentially confirms there is direct link between the emotions and the physical body (for example 7,8).

In diseases like fibromyalgia there is almost always a very strong emotional aspect of the disease, most often depression but also anxiety, restlessness, irritability and low affect are commonly experienced.  It is, from a TCM perspective, essential for the overall effectiveness of the treatment to consider and address the various emotional components involved with fibromyalgia.  Much of the time Western oriented treatments either ignore outright the emotional component of fibromyalgia or prescribe some sort of psychotropics i.e. antidepressants, which are generally not effective (9).

Another issue many patients face from a western perspective is that fibromyalgia often presents with multiple symptoms and doctors tend to focus on only a few.  For example gastrointestinal troubles are a common symptom, and many general practitioners will do nothing to address GI issues, referring to Gastro-intestinal (GI) specialists instead.  The GI, in return, may largely ignore the pain and emotional aspects  and just focus on treating the GI symptoms.  Or perhaps the GI then refers to a psychiatrist for the anxiety/depression, and so on.  In worst case scenarios doctors don't even look at the meds other doctors have prescribed, which is among the reasons drug interactions are a leading cause of death in this country (10).

For complex diseases like fibromyalgia, what often seems like a hopeless tangle of various symptoms is often relatively straightforward from a TCM perspective.  The hallmark of TCM is that we are able to treat the patient as a whole, in effect addressing all symptoms all at once by identifying the underlying imbalances that generate those symptoms.  Now this doesn't mean everything will get better all at once, generally the symptoms that are mildest or have been around for the shortest duration improve first, but again everyone is different.  However pretty much across the board the various symptoms fibromyalgia patients should start to improve after several acupuncture treatments.