Published on the Internet site WebMD*, May 2, 2001:

These Brain Waves May Tame Fibromyalgia

Electrotherapy Looks Promising — but Are Results Too Good to Be True?

By Peggy Peck

Reviewed by Dr. Gary D. Vogin

May 1, 2001 — As many as six million Americans are living with fibromyalgia, and in most cases they are living with the constant, unrelenting symptoms of the condition: widespread pain in muscles and joints, sleep disturbances, irritable bowel syndrome, and anxiety, to name a few. But very positive results from a new study suggest that sending mini-currents of electricity through the brain — a procedure called cranial electrotherapy stimulation –may provide relief from some of these symptoms.

Alan S. Lichtbroun, MD, says he learned about the electrotherapy technique while searching for better treatments for his many fibromyalgia patients.

“This technique is gaining wide acceptance at chronic pain treatment centers,” says Lichtbroun, assistant professor at Robert Wood Johnson Medical School, in East Brunswick, N.J. “At first I looked at this device very skeptically — and even now I am beginning to see some patients who had a marked response at the beginning are gradually beginning to deteriorate — so again I wondered if the machine had lost its power. But what I’ve found is that patients eventually lose their incentive to use the machine, and less frequent use appears to mean a return of symptoms.”

The machine Lichtbroun refers to is the Alpha-Stim CES device made by Electromedical Products International Inc., of Mineral Wells, Texas. Patients using the device clip electrodes to their earlobes, which transmit low levels of electricity back and forth, through the head.

In the study, published in the April issue of the Journal of Clinical Rheumatology, 20 patients were assigned to two groups, one that got cranial electrotherapy stimulation and another that got fake devices clipped to their ears that didn’t transmit electricity. Because the electric currents are so low they cannot be felt as they pass through the brain, participants didn’t know whether or not they received active stimulation.

Both groups were told to use the devices for an hour a day for three weeks.

For therapeutic use, patients are taught how to use the devices so that “they can undergo the treatment in their own homes, at a time that is convenient for them,” says Lichtbroun.

That’s a big advantage over some other approaches, such as massage, because it doesn’t require “special appointments or a trip outside the home,” he points out.

The results of the electrotherapy treatment were “very surprising,” says Lichtbroun.

Physicians determine how severe a case of fibromyalgia is by testing “tender points” — areas of highly localized pain. The study participants who had real electrotherapy treatment had a 28% improvement in tender-point scores and a 27% improvement in the amount of general pain they felt.

But most surprising, says Lichtbroun, was that only 5% of the treated patients reported having sleep disturbances after treatment, compared with 60% who had sleep problems before beginning electrotherapy treatments.

And 90% of the treated patients reported that their quality of life had improved as a result of treatment, while 20% of the patients who were in the fake treatment group said their quality of life had declined.

These results are almost too good, says Robert S. Katz, MD.

“Fibromyalgia is a very challenging condition from the standpoint of treatment,” says Katz, associate professor of medicine at Rush Medical School, in Chicago. “I would be very impressed with a treatment that had a 50% improvement, but 90% makes me very skeptical.”

Some other treatments have claimed equally impressive initial results, Katz says, but the improvement is seldom long-lasting.

“I would like to see some findings on the long-term results of this treatment,” he says. Even in the short term, Lichtbroun’s findings “need to be reproduced by other investigators before we can consider recommending this treatment,” he adds.

Lichtbroun says he, too, would like to see the findings replicated in another study. Until then, he says, he is offering all his fibromyalgia patients “one free treatment with the devices.”

Offering a freebie treatment is important because the electrotherapy devices range in price from $400 to $700, he says. “Some insurance companies will pay for the device, but many won’t, and so the patient has to pay for it.”

© 2001 WebMD Corporation. All rights reserved

http://www.alpha-stim.com/repository/assets/pdf/gilula_fm.pdf

The Yin and Yang of Fibromyalgia Syndrome: Treatments Based on the Ancient Wisdom of Traditional Chinese Medicine

by Debra Clydesdale LAc DNBAO QME

Many fibromyalgia patients find themselves in my office, some referred by physicians as a last resort and some coming to me independently. Many hold up a bag of medications they say that they don’t want to take anymore; they don’t like the side effects, they feel like zombies, confused and tired, or their libido is diminished. Or they have seen many practitioners and nothing has helped them much. They are looking for a different way to treat their symptoms. I say “different” because Eastern and Western Medicine are both useful in their own ways. I would not want to live in a world without either one. Each has areas in which it shines, but there are few people who know which is best for each individual situation. This is especially true for the multitude of chronic and autoimmune syndromes that are so prevalent today. It is estimated that as much as six percent of the U.S. population has fibromyalgia (FM). My focus is to help patients with the knowledge, treatments and resources we have researched and developed over the years, as well as what has been known from over 5000 years of Oriental Medicine. The purpose of this article is to provide a brief overview of how Traditional Chinese Medicine (TCM) views FM, and to shine a light on what it has to offer for FM patients in who want to restore their health and vitality.

Constitution vs. Lifestyle
We come into this world from the union of father and mother to develop from a tiny microscopic zygote to a wondrous pinkish, precious baby. As we come from the inheritance of father and mother, we enter the world with what we call “constitution” in Chinese Medicine, which includes everything from our DNA to our spirit.As each one of us is unique, we have gifts and challenges, strengths and weaknesses, or in the nature of TCM, what is called a blending of Yin and Yang. This philosophy is the root of Chinese Medicine. The concept of Yin and Yang is a constant interaction and rebalancing process of two opposites. Simply, neither too much of something (excess) nor too little of something (deficiency) is good. An ever present re-balancing is necessary for optimal health. In our unique constitutions, we each have a deficiency that creates an imbalance in how the body functions. As we go through life, we make different choices to make up for this imbalance depending on our personality, parents/caretakers, environment, resources and lifestyles. These different choices influence our development and how our bodies function, and each one of us ends up with a unique pattern of functioning and symptoms. Many patterns are common to various groups of people, but as any acupuncturist who specializes in TCM will confirm, each person has his very own, unique properties. Often we know that these symptom patterns are there, but when we talk about them to others— our parents, siblings, peers, even doctors—they are often dismissed. I have experienced this myself, either because others don’t feel that way themselves; or it seems inconsequential or strange to them; or the symptoms are considered sub-clinical; or they’re not a disease process yet and don’t mean much to the Western clinician. When we’re told these patterns should be ignored or don’t matter, we feel not quite right about what is happening in our bodies.
These seemingly minor symptoms mean quite a bit to the TCM practitioner. They are the keys to helping one move towards more vibrant and vital health. By addressing these patterns earlier we may also see shifts in the chronic aliments that plague us, such as fibromyalgia and other chronic disorders.

Fibromyalgia – TCM Patterns and Progressions
Fibromyalgia is categorized as ji bi (muscle impediment) in TCM. There are three other main specific patterns within this syndrome: xu lao (vacuity taxation/fatigue), yu sheng (depressive condition/depression) and Shi mian (insomnia). Each of these patterns has a slightly different symptom picture depending on the root of the imbalance. In TCM, the core of fibromyalgia syndrome is what we call Liver-Spleen disharmony. This pattern sits squarely in the center of all other patterns associated with fibromyalgia. You may have heard the term “meridians.” In TCM these are actually referred to as jing luo, the major longitudinal distributions and collateral vessels otherwise known as the neurovascular system. Healthy flow and function of this system leads to health and vitality. There are 12 main pairs which are each related to different organs each containing a yin organ and a yang organ. In this view the liver and spleen are much more than just organs; they are a pattern of functioning in the body that include the physiological reach of the distribution that feeds it. For now, in a Liver-Spleen disharmony this may mean that either the “liver” is too weak or too strong due to poor diet or repressed anger, and/or the “spleen” is weakened from over-worrying or ongoing and unrelenting stress.

It all is reflected in the brain
The unique constitutional patterns and ongoing additional lifestyle burdens add up and manifest as abnormal neurotransmitter/receptor patterns in our brains. Our brains and our bodies interact just like yin and yang, each affecting the other. Research on fibromyalgia syndrome points to problematic insomnia and lack of restorative sleep, pain, anxiety, and depression—all related to a neurotransmitter/receptor dysfunction in the brain. The brain isn’t sending the right messages to our bodies. A substantial literature exists supporting acupuncture’s variety of neuro-chemical and other physiological effects. It has been reported that acupuncture at traditional points produces dramatic effects in EEG, blood flow, and breathing rate as compared to non-traditional points. Various studies also linked acupuncture to the production of endogenous opiate peptides, such as beta-endorphin and met-enkephalins, which is speculated to be a physiological mechanism behind the treatment’s effects on withdrawal discomfort. Acupuncture has also been related to changes regarding other neurotransmitters, including ACTH and cortisol levels, serotonin, and 5-HT.

What does this mean for fibromyalgia sufferers?
Acupuncture helps our bodies return to normal functioning. It is the gentle stimulation of different points on the body which creates a rebalancing effect in the brain. Each treatment addresses both the root, or underlying pattern, and the branch, or the annoying symptom or reason the patient came into the office. If both are not addressed, the results will either not be effective, or they will be short-lived and patients will need to keep returning for treatments. I also prescribe the Alpha-Stim CES (cranial electrotherapy stimulation) device for home use so patients have the maximum effect from their treatments with the lowest cost and the least in-office time. (The Alpha-STIM includes electrodes that clip onto your earlobes; the electrodes send electronic currents, similar to those naturally found in the body, into the brain.) Coming in three times a week for acupuncture treatments is often impossible for patients. I have had excellent results by including a home unit for patients, as the Alpha Stim CES helps restore homeostasis in the brain—a result similar to the one achieved by acupuncture—as well as treats concurrent insomnia, depression, anxiety, stress and pain. Three rigorous double-blind studies published on FM in peer-reviewed journals have concluded that CES appears to be an effective, well-tolerated treatment for fibromyalgia. This supports what I have seen in my practice. As the brain is restored to better function, improved signals are sent to the body, which then begins to work better as well. Along with decreasing anxiety, depression, insomnia, stress and pain, the Alpha-Stim also helps patients with cognitive functioning and increases alertness and relaxation when appropriate. I often have patients begin to do mindfulness exercises and awareness breathing, which helps them tap into the self-healing and restoring capabilities that exist in their bodies. These are often difficult for people at first, as they are used to only noticing how their bodies don’t feel good, and where it hurts. The Alpha-Stim can be a powerful tool to help them re-discover the wonderful healing resource that their bodies are for them.

You are what you eat and you eat what you crave
Nutrition is also a fundamental key aspect as food provides the building blocks for our daily functioning. I work with patient’s diet according to Chinese Dietary Therapy and Chinese Nutritional Principles. This can be a fundamental tool in restoring the depletion that has occurred in a fibromyalgia sufferer’s body, and in reducing craving that drive many people to eat poorly. I have seen food and environmental allergies go away, cravings for sweets, breads and sugar disappear, energy levels improve so much that mothers had enough energy to play with their children at the end of the day again, and even SLE lupus go into remission. Some patients have gone off their medications under the direction and with the blessing of their physicians. Exercise is also vitally important. We were meant to move. I often teach patients Qi Gong, which is a powerful movement system which restores micro-movement capabilities of the body. Movements are done slowly (as slow as blood flow) and with awareness. This has been shown to restore even blood flow to the body. Yoga, Pilates, and aerobic conditioning are wonderful as well.

If you are looking for a different way
I have helped patients by doing just one or two of the above treatments, integrating them with their current medical program. I have also created complete programs for patients according to Traditional Chinese Medicine. Some were helped more than others. We have found that the key is commitment to slow and steady progress. The turtle always wins here.