There are few diseases as controversial in conventional medicine as Fibromyalgia. I’ve talked to colleagues who can recite all the physiologic changes that occur in a patient with Fibromyalgia and do not have any doubts that this is a real disease. I have other colleagues that don’t believe it’s a real disease at all and is actually a psychiatric illness. My opinion is that it is absolutely a real disease but not one that can be managed very well by the conventional approach that uses antidepressants, seizure medications, NSAIDs and/or other pain medications. The reason this approach doesn’t work is that fibromyalgia is a complex, multifactorial disease.
There is an epidemic in the developing world of chronic diseases and all of them are complex and multifactorial (just like Fibromyalgia). These diseases include Alzheimer’s disease, Diabetes, Stroke, Cancer, Heart Disease, Hypertension, Fibromyalgia, autoimmune diseases and many others. Many of these diseases are thought to be a consequence of aging (another blog post will cover this). However, whatever way you look at it, most people in the developed world will die from one of these diseases, but it was not always this way. Prior to the age of antibiotics and adequate sanitation, most people died from infectious diseases, and this is still true in many countries in the developing world. It was out of this world of treating infections that conventional western medicine was born. Western medicine was initially concerned with using the right medication to cure the infections that were ubiquitous in this age. However, this model is completely inadequate today because we are no longer dealing with a single cause of disease that can be treated with a single medication.
Which brings us back to Fibromyalgia. I don’t think any other chronic disease is more ill served by conventional medicine than fibromyalgia. These patients are often “trialed” on many different classes of medications, few of which actually provide any relief. It is also not uncommon for these poor folks to be put on an opiate pain medication that may lead to other worse problems down the line, including addiction. The fact is that every aspect of a person’s lifestyle (sleep, diet, movement, social networks, etc.) either improves or worsens their disease. The functional medicine perspective is very different from the conventional approach and accepts that there is no single factor that causes fibromyalgia, but instead, many factors that can contribute to it’s development. These factors include chronic inflammation, certain vitamin or mineral deficiencies, thyroid disease, gut dysbiosis, food sensitivities, adrenal issues, sleep problems and many more. I have been able to help many patients improve or resolve (or put into remission if you prefer) their fibromyalgia by addressing their disease in more of a holistic fashion. My goal is always to try to find the root causes that have tipped this person towards the diseased state and away from the healthy state. Modern medicine can perform miracles in some cases using a drug or surgery to cure a disease and save lives. In fact, these heroic efforts do save lives every day and are a true testament to the technological progress that has been made in medicine (particularly emergency and trauma medicine). However, today’s physician must also begin to address the totality of a patient’s life if they truly want to treat and prevent chronic disease.