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Stop Suffering From Fibromyalgia!

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Fibromyalgia and the
MindBodySpirit Connection

by William B. Salt II, MD and Edwin H. Season, MD
View Table of Contents

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If you have unexplained body pain or have been diagnosed with fibromyalgia—or suspect that you might have fibromyalgia—then this book is for you. Furthermore, many people with certain types of arthritis, like osteoarthritis, and soft tissue rheumatic conditions also have fibromyalgia. If you have one or more of these conditions, then this book can help you too.

An Epidemic of Pain and Symptoms
There is an epidemic of musculoskeletal pain and discomfort in the Western countries, and the problem is getting worse. This pain involves the limbs of the body, the back, and the neck. Many patients with widespread body pain are diagnosed with what is called fibromyalgia. Disability from pain and fibromyalgia is increasing every year in American industry.

What Is Fibromyalgia?
Fibromyalgia is defined as widespread muscular aching, pain, and stiffness associated with tenderness on palpation (pressing the finger or thumb) on specified sites called trigger (tender) points located mainly in the neck, back, and extremities. These trigger or tender points are illustrated in Figure 1.

Other names for fibromyalgia include fibrositis, fibromyositis, and generalized myofascial pain. Table 1 shows that the pain of fibromyalgia is widespread.

TABLE 1 Location of Pain in Fibromyalgia
Base of Skull Neck Shoulders
Back Chest Arms
Legs Buttocks Hips

What Is Myofascial Pain?
Myofascial pain syndrome is regional or localized fibromyalgia. Instead of being widespread, the pain and tenderness are found in a localized area of the body, the most common being the upper back, shoulders, and lower back. The muscles are very tender to any pressure, and nodules or lumps can often be felt within these muscles. The range of motion of nearby joints may also be limited.

Millions of People Are Affected
A study published recently in a medical journal indicates that fibromyalgia affects 2 percent of people in the United States. Fibromyalgia is ten times more common in women than in men. There is a progressive increase in the prevalence with age, such that about 7 percent of women 70 years of age are affected (Arthritis and Rheumatism, 1995).

Major Women's Health Problem
Most of the millions of Americans who suffer from fibromyalgia are women. Fibromyalgia is the most common cause of generalized musculoskeletal pain in women between the ages of 20 and 55. Fibromyalgia is the second most common diagnosis made by rheumatologists. It is a major women's health issue and receives considerable media attention in newspapers, magazines, radio, and television.

Fibromyalgia: Worldwide Problem
Fibromyalgia has been described in most countries of the world. It does not appear to be related to ethnicity and is not a problem related to colder climates.

Fibromyalgia versus Arthritis
The muscles, tendons, ligaments, and joints are not inflamed in fibromyalgia as they can be in diseases like arthritis or myositis (inflamed muscles), so it is important to make the distinction with proper diagnosis. However, many people who do have these arthritic and inflammatory diseases also have fibromyalgia, so they too can benefit from the treatment advice offered in this book. Furthermore, it is a mistake to attribute the pain of fibromyalgia to coexisting arthritis or x-ray findings, and you will learn how this can interfere with healing.

Fibromyalgia: Consequences
Here are the consequences for many who suffer with fibromyalgia:

  • Reduced sense of health and well-being
  • Constant concerns related to the cause of the symptoms
  • Sense of loss of control
  • Reduced activity and exercise
  • Difficulty with the activities of daily living
  • Problems with interpersonal relationships with family, friends, and coworkers
  • Disability with missed workdays

Fibromyalgia causes symptoms and discomfort ranging from mild and inconvenient to severe, resulting in incapacitation and disability. Current evidence shows that many patients with fibromyalgia lead restricted lives in multiple areas, including reduced physical activity, missed social opportunities, and lack of enjoyment of life. Many do not obtain much relief from current health care practices and medications.

So Many People with So Many Symptoms
Most people with fibromyalgia also have other unexplained symptoms, the most common of which are difficulty sleeping and fatigue. There is a virtual epidemic of body symptoms that have no apparent cause. In such cases, all of the tests—including physical examination, blood tests, x-rays, endoscopic examinations, and biopsy results—are normal. These symptoms that cause people to consult with doctors and that cannot be explained by tests are called "functional," "psychosomatic," or "somatization symptoms."

The symptoms listed in Table 2, including those of fibromyalgia, are the most common symptoms for which people consult with primary care doctors. Yet, a specific disease accounting for these symptoms can only be found in 10 percent to 20 percent of patients, or in one to two of every ten patients who consult with a doctor!

Table 2 Most Common Body Symptoms Are Functional (Tests Are Normal)
Fatigue and low energy* Shortness of breath
Insomnia and difficulty sleeping* Chest pain
Gastrointestinal (IBS) Abdominal pain
Headache Back pain
TMJ (pain in the jaw) Pelvic pain
Dizziness Painful menstrual periods
Feeling faint Decreased sex drive
Difficulty concentrating Bladder problems
* The most common symptoms associated with fibromyalgia

People with Symptoms Become Patients with Functional Syndromes
Recognition of these "functional symptoms" leads to diagnosis with what doctors call "functional syndromes," or collections of symptoms that cannot be explained by medical science. People with functional symptoms who go to see a doctor become patients with functional syndromes. The main symptom and the type of doctor or specialist that a person sees usually determine the syndrome diagnosis that he or she first receives. As an example, the rheumatologist diagnoses widespread musculoskeletal pain as fibromyalgia; the gastroenterologist diagnoses abdominal pain associated with bowel changes as irritable bowel syndrome; the dentist diagnoses jaw pain as temporomandibular joint dysfunction; the infectious disease expert may diagnose chronic fatigue and flu-like symptoms as chronic fatigue syndrome (CFS); the urologist diagnoses difficulties with urination as irritable bladder syndrome or interstitial cystitis; and the gynecologist diagnoses pelvic discomfort and pain as chronic pelvic pain syndrome.

Are These Symptoms and Syndromes "All in the Head"?
Unfortunately, terms like "functional," "psychosomatic," and "somatization" are often interpreted to suggest that the symptoms are "all in the head," phoney, or imagined. The truth is that the symptoms are very real. In fact, virtually everyone experiences one or more functional symptoms (or syndromes if diagnosed by a doctor) from time to time. However, some people have symptoms that are frequent, constant, and severe, which causes them to consult with doctors. The suffering is enormous; it is personal, social, and economic.

What is going on here? What is the common denominator? The answer is that the problem is not "all in the head" but is related to the connection between the brain (mind) and body.

The MindBodySpirit Connection
You will learn that mind and body are one. It no longer makes sense to classify problems as either stress/emotional related (mind) or physical (body). Furthermore, you will discover why it is essential that the mind-body connection include spirit; scientific evidence continues to confirm the mysterious power of spirit and how affirming beliefs—particularly belief in a higher power—can contribute significantly to health.

You will study the neurochemical basis of the mind-body-spirit connection. You will learn that there are three systems of communication.

We will propose a new language in this book for people with functional symptoms, patients with functional syndromes, and the doctors who diagnose them. The four new terms that we will introduce are the following:

  • MindBodySpirit Connection
  • MindBodySpirit Symptoms
  • MindBodySpirit Syndromes
  • MindBodySpirit Healing
You will appreciate that MindBodySpirit Healing is based upon the recognition and acceptance of the connection between mind, body, and spirit, the distinction between treatment and healing, the innate healing potential of the body, and the power of the partnership between the patient and doctor/health professional in restoring health.

You will understand fibromyalgia as a MindBodySpirit Syndrome, which is a collection of MindBodySpirit Symptoms. You will better appreciate the "cause" of fibromyalgia by understanding the biopsychosocialspiritual model, the MindBodySpirit Connection, and systems thinking.

Why a Book about Fibromyalgia?
There have been new developments in the diagnosis and treatment of fibromyalgia and other soft tissue rheumatic disorders. Furthermore, everyone (people with symptoms, patients with syndromes, and doctors who diagnose them) can become more aware of a person's ability to heal from MindBodySpirit Symptoms and MindBodySpirit Syndromes by understanding the MindBodySpirit Connection and leading a healthy lifestyle.

The impact of "managed care" means that your doctor will have less time to spend with you. In fact, most doctor visits are now limited to 12 minutes or less! This does not leave much time for diagnosis, education, and treatment. It may also be difficult and expensive for you to see a specialist because the managed care system expects that your primary care physician should be able to handle most problems.
The model of interaction between patient and physician is changing. YOU are given more responsibility in the management of your own care. You will need and must have accurate and reliable information in order to fulfill this personal responsibility and opportunity.

The Power of Knowledge
You gain the upper hand by understanding the MindBodySpirit Connection and by an appreciation of the impact of perceived stress, emotional distress, thought, and memory on the conscious and unconscious mind, body, and spirit. Just knowing the "cause" of fibromyalgia is beneficial. Focusing on the power of your mind rather than on the pain and diagnosis of your body can bring lifelong relief.

With this book, you can explore your diagnostic and treatment options in the privacy of your home and on your own time. Then, armed with information and knowledge about your problem, you will be better able to partner with your doctor in order to heal.

You Can Heal!
Your mind, body, and spirit are connected and inseparable. You will learn that you are stronger than you ever thought and that you have more control over your body than you realized. The goal of this book is to show you that the illness of fibromyalgia is a MindBodySpirit Syndrome and to provide the tools for you to access the miraculous ability of your body to heal through the MindBodySpirit Connection. Furthermore, your problem can be the stimulus for a life change that will bring you better health and wellness than you have had before.

Learn to Be Healthy
You can learn to be healthy. Accurate information leads to healing and is often much more important than medication. Achieving health and wellness is an active, rather than passive, process. The focused information on fibromyalgia in this book is integrated with holistic MindBodySpirit Connection concepts and the latest information on living a healthy lifestyle.

It may take you up to twelve weeks to read this book and walk through the seven steps listed in Table 3. Change is never easy, but then neither is it easy to live with fibromyalgia. Behavioral psychologists have studied people who have succeeded in changing their lives. Research shows that it takes about 12 weeks to make the commitment, begin to change behavior, and to establish an enduring life change.

Table 3: 7 Steps for Living a Healthy Life with Fibromyalgia
Step 1: Connecting Mind, Body, and Spirit
Step 2: Learning about Fibromyalgia and Myofascial Pain
Step 3: Healing with Diagnosis and Education
Step 4: Making "The Connection"
Step 5: Emphasizing Self-Care and Wellness
Step 6: Managing Your Fibromyalgia
Step 7: Taking Action If Symptoms Persist

"Use" Fibromyalgia
Not only can you heal from fibromyalgia, but also you can be healthier than you have ever been. Turn the negative of your illness into the positive of health and wellness. You can "use" fibromyalgia to change your life and health. Focus on the power of your mind rather than on the pain of your body. Use the diagnosis of fibromyalgia to realize your ability to heal through the MindBodySpirit Connection and become healthier than ever before. Welcome to wellness!

William B. Salt II, MD
William B. Salt II, M.D.
Columbus, Ohio
Author of:
Irritable Bowel Syndrome & The Mind-Body/Brain-Gut Connection

Edwin H. Season, M.D.
Edwin H. Season, M.D.
Orthopedic Surgeon
Columbus, Ohio

Fibromyalgia and the
MindBodySpirit Connection

by William B. Salt II, MD and Edwin H. Season, MD
View Table of Contents

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