Take any two individuals with fibromyalgia and you’ll find they experience it in different ways. Chinese medicine needs those unique and different ways to decide which ‘syndromes’ are relevant.
Because everyone has his own combination of symptoms, the diagnosis – the ‘syndrome(s)’ – will be different in each case, and so will the treatment, because the treatment depends on the syndrome(s) in question.
It also means that someone with one disease as diagnosed in Western Medicine may have the same (Chinese medical) syndromes describing it as someone with another (Western diagnosed) disease. In which case they might share the same treatment! So …
Two individuals with the same ‘disease’ – but different treatments
Two people each with a different disease – same treatment
That means that everyone is treated as an individual. No one treatment suits everyone.
However, let’s put aside acupuncture theory and treatment for a moment and think about the agreed symptoms of fibromyalgia.
Typical symptoms in Fibromyalgia
Here’s the problem! … It’s got all sorts of symptoms that you may or may not have! They include:
Chronic Pain and fibromyalgia
This chronic pain can be all over or widespread throughout your body. It can be severe in places and not in others. The pain may vary, but it’s usually always there to some extent. Often your neck and your back are particularly sore.
Pain is a big subject in Chinese medicine. Read more here.
What kind of chronic pain?
Aching. The ache may be like influenza, or it may throb
Nervy, shooting pain down your legs or arms
Exquisitely sensitive to touch
Sensitivity, including to touch
This means that someone gently holding your arm may actually be hurting you. For example, if you accidentally hit something with your elbow, the pain may continue for hours.
This sensitivity can extend to smells, sunlight or bright light, smoke and perfume. It’s as if your body is hyper-alert to stimuli that other people either don’t mind, or may even like.
This could mean that you dread visiting a friend’s house if your friend likes flowers with strong perfumes. Your friend may find it hard to understand why you don’t want to visit!
In Western medicine, this is due a heightened sympathetic nervous system.
In Chinese medicine, it boils down to excess yang and deficient yin. However, the actual syndrome(s) diagnosed depend on your individual reactions and pain characteristics.
Chronic Fatigue is common with Fibromyalgia
Chronic fatigue is bad enough for anyone. For you this is ongoing, heavy, dragging. Combined with pain, it is a burden for you that others will find hard to understand. Rest or sleep often don’t make much difference, though you always feel you need more sleep. Sometimes, movement and warmth make it a little better.
This chronic Fatigue can be mild, or like influenza, totally debilitating. It can vary, sometimes without apparent reason. The weather may affect it.
Your diagnosis may be chronic fatigue syndrome (CFS) in addition to your basic fibromyalgia: or they might diagnose CFS first.
Fibromyalgia slows your brain and your thinking. Concentration and memory suffer, and you may find your speech slurs, or you can’t articulate sentences properly. Some medications prescribed by your rheumatologist may originally have been used for epilepsy, even though for you they are for pain.
Perhaps surprisingly, that those drugs for epilepsy may sometimes work makes some kind of sense of in Chinese medical theory – see below.
There are various explanations for all this in Chinese medicine. These include syndromes such as:
Cramps and spasms which are like, or are diagnosed as, irritable bowel syndrome. With deficient ‘Spleen‘ Qi, which underlies many other syndromes for fibromyalgia in Chinese medicine, you often get what is called ‘Liver over-acting’ – see Liver Qi stagnation.
Stiffness and fibromyalgia
Overwhelming stiffness slows you down after resting still for a while. Keeping moving may partly hold it in check. After sleep the first movements can be really difficult.
Sufferers say it can feel like being in treacle: really hard to get moving, though usually (a bit) better once you get going.
You may find a warm bath helps get your body get moving in the morning.
Acupuncture theory offers a great way to understand this Fibromyalgia stiffness!
Through stiffness, you may be a slow walker.
This stiffness is a major pointer to what Chinese medicine calls Damp.
Some parts of your body feel too hot, others too cold, and parts of your body seem to be at a different temperature to the rest of you.
There are various possible syndromes for this in Chinese medical theory, including Blood deficiency. But it is also arguable that Qi – energy – cannot move properly because it is both deficient, and hampered by Damp.
Legs and fibromyalgia
Twitchy, restless legs are common. Many get leg cramps.
Restless leg syndrome, a Western medical ‘condition’ is often due in Chinese medicine to Blood deficiency, or Blood Stasis, or again, Damp, slowing the movement of Qi.
This is a high-pitched ringing or hissing sound in your ears or head. It too can vary. If it does vary, from the point of view of the theory it may be easier to help.
If it’s always there at the same intensity, it is more difficult to help.
Tinnitus can be explained in Chinese medicine by several syndromes, the main one being Kidney Deficiency with Liver Yang Excess.
Fibromyalgia and Depression
Depression can be occasional or frequent or indefinite: this tends to come on as a result of fibromyalgia.
Depression is unlikely to be a cause of fibromyalgia.
Fortunately, when the depression is recognizable as a syndrome (eg Qi Stagnation) in Chinese medicine, acupuncture may be able to help.
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Tingling and burning, nervy type pains. I’ve found this best diagnosed as Blood deficiency and mild internal Wind.
Because the symptoms are so varied, it’s hardly surprising that fibromyalgia sufferers often get depressed.
What does ‘Western’ medicine, and your rheumatologist (because that’s probably who will be looking after you) offer for fibromyalgia sufferers?
For pain, there are analgesics like paracetamol. Also, sometimes, anti-depressants are used for this pain, not necessarily because the patient is depressed, but because – for some people – they work.
Muscle relaxants and anti-convulsants may also be used, because fibromyalgia sufferers often get cramps and spasms: again, not necessarily because they have a tendency to epilepsy.
Because sleep is sometimes difficult, medication for this is often prescribed.
So fibromyalgia sufferers can find themselves taking a whole range of medications, prescribed by their rheumatologist who is, after all, doing his or her level best for the patient.
You, as the patient, have your own unique physiology and metabolism, and some medications may not agree with you, nor with one another. Finding the best ‘mix’ can take time and patience from both you and your doctor, if this is the route down which you travel.
Other possibilities include psychotherapy, psychological support and cognitive behavioural therapy, to help you work out good ways to deal with the condition.
You may also need to see a physiotherapist. Your physiotherapist may suggest exercises to do, and possibly hydrotherapy.
From the point of view of Chinese medicine, every therapy has its good and bad points. So for example, hydrotherapy might be a good choice for some but probably not for others where ‘Damp’ as explained on this page, is prevalent.
What can acupuncture theory offer?
The main syndrome covering this, in Chinese medicine – ie fibromyalgia acupuncture theory – is what is called ‘Damp’.
Damp is like a thick heavy mist. It coats everything, making it heavier and slower; obscures thinking; often makes things swell or stiffen up. The less you move the more damp collects.
The only things that help damp are warmth and movement. As with the damp skylight in the picture, if the room were warmer, or there were a good draft, there wouldn’t be damp!
So for fibromyalgia acupuncture theory says what?
Damp occurs when what is called your Spleen energy is weakened.
In Chinese medicine your Spleen energy is said to transform what you eat into energy and blood and transport it round the body, removing the old and replenishing with new. It builds muscles and healthy flesh; it separates pure from impure and sends the best to the other organs (liver, heart, kidney, lungs).
Crucially, for us, it separates pure from impure fluids and this is where, if weak, damp can arise.
If your Spleen energy is working well, and you are eating enough healthy food, your digestion will be good. If your Spleen energy is below par, your appetite suffers, you may have bad digestion, abdominal distension and your bowel movements may be affected with loose stools.
Your Spleen energy is also affected by external damp, such as the weather when it is humid or raining. Most people don’t notice this, but as you become more Spleen deficient, symptoms become obvious.
If Spleen energy is weak, so will be your thinking. Your thinking processes will be confused, dull, slow, tired, forgetful; your concentration poor.
Unfortunately for students, too much intensive thinking, such as long periods of study or concentration can weaken the Spleen.
From personal experience I can tell you that this also happens if you worry about difficult cases (of patients) for too long!
So can worry and sustained periods of anxiety.
The Spleen’s energy is weakened by the wrong foods, (eg raw, sweet or very rich food, cold or iced food or drink) or eating too fast or irregularly. Some foods and herbs nourish it, like ginger. So in Chinese medicine, a typical diet for fibromyalgia might exclude these ‘wrong’ foods and include warming herbs and dishes.
Just as a weak Spleen enables Damp to collect, Damp can block the action of the Spleen. When the Spleen action is blocked, Liver energy (read about Liver energy problems here) often becomes too powerful, causing cramps, spasms, pain and irritability: this can lead to Liver Qi stagnation, which is one of the syndromes that resembles depression.
When Liver energy isn’t working properly, sleep isn’t refreshing and headaches are common. Also, when deficient Blood occurs, you can sometimes get Liver Wind symptoms, which in the extreme are a syndrome noted in epilepsy.
Other syndromes in Chinese medicine
Other syndromes in Chinese medicine that cause some of the fibromyalgia symptoms include ‘cold’. Cold slows things down – stiffness – and causes stabbing pains.
For some symptoms in fibromyalgia acupuncture theory has to look to other syndromes in Traditional Chinese Medicine. The acute sensitivity, for example, can arise in several ways, damp being only one of them.
Tinnitus more commonly arises when Kidney energy is weak: it’s not so often a Spleen energy problem. (Though if the Spleen energy is weak, Kidney energy can get out of control via something known as the K’o cycle.) When Kidney Qi is weak, often Liver Yang isn’t ‘restrained’, giving Liver Yang excess with irritability, tension, tinnitus and headaches.
Twitchy, restless legs aren’t usually an early symptom: they develop later.
This is because as time passes and Spleen energy fails to extract good energy and blood from food, then send it to the other organs, the latter gradually weaken too. As they do, syndromes associated with them start to appear.
Cramps in the legs can also develop when there is a deficiency of Liver Blood, for example, or when Liver Blood stasis occurs. Both of these can be a direct result of Spleen energy not producing enough Blood in the first place.
This condition may be behind the ‘Damp’ syndrome, both as an underlying original cause and as an effect of it. Not surprisingly, fibromyalgia makes sufferers very upset. When they get upset, this exacerbates their Qi Stagnation. That makes their condition often worse again, a kind of vicious circle.
So part of the treatment, in Chinese medicine, may be
to ‘relax’ the Qi stagnation,
then to ‘clear the Damp’ and
eventually to strengthen the Spleen.
help with the pain: there are various syndromes here.
Fibromyalgia Treatment with
Once again, do realise that we are not claiming that acupuncture for fibromyalgia will be curative, merely that many of the symptoms of the condition resemble syndromes in Traditional Chinese Medicine which fibromyalgia acupuncture theory says ARE treatable, though not necessarily curable.
What is more, Damp can be very hard to cure. In Chinese medicine it can take quite a bit of treatment to clear it. Western, orthodox, medicine struggles with fibromyalgia – and in this case don’t expect miracles from other therapies.
Sometimes other forms of treatment may help, such as herbs and guasha, moxibustion and gentle exercise such as Tai Chi. Avoiding some foods may be important for some people. Worry and Stress can exacerbate the situation. So for even fibromyalgia syndromes acupuncture can’t do everything!
Also, this is not a condition for Do-It-Yourself or self-acupuncture. You need an experienced therapist who may try a number of approaches, and combine them with treatments of other kinds or treatments of other syndromes besides that of Damp or Weak Spleen.
There is evidence that electro-acupuncture is more effective than manual acupuncture but even so, the points chosen are extremely important. (Acupuncture for treating fibromyalgia. Cochrane Database Syst.Rev.2013 May 31;5:CD007070)