Questions & Answers

Answer: The Mind Heals Approach is a philosophic approach that supports and maximizes the healing that can occur with all effective medical treatment. At Healing Choices we can work with individuals who have a variety of chronic medical conditions such as Parkinsons who are interested in exploring drug free treatment options as part of an integrative interdisciplinary approach. We work in collaboration with the patients primary care physician and other specialists such as neurologist based upon patient need.

Answer: You are correct, this approach is not always supported. However, if you are not able to identify a team that shares this philosophy, I would suggest a couple of points to consider. -It may be worth travelling in some situations to get the type of care and support that you need. -Create your own team. If one does not exist in reasonable proximity. Interview different practitioners to find out if they are willing to work together in partnership with you. Do not forget to ask others if they are familiar with a team or practitioners who have the expertise and philosophy you are looking for. -Remember that you are the most important member of the team. If you do your own research, have a positive attitude and take responsibiliy for your health and healing, while being open to your own intuition you will do well.

Answer: In addition to the x-rays that were done, if not already ordered, basic lab work might be useful as well as a full physical exam that includes assessment for tender points. Obviously, a more detailed history is needed which would also lead your physician to appropriate testing. If your primary care physician needs further assistance with the evaluation process, then a specialist may be appropriate. This is a discussion that you would need to have with your primary care physician.

Answer: Although visual symptoms can be present without any other diagnosis once a thorough opthalmologic exam is done, the constellation of symptoms does not seem typical of this diagnosis. I would strongy urge you to have this evaluated further by your primary care physician and/or an appropriate specialist.

Answer: The chinese medicine approach includes acupunctue in conjunction with diet, proper exercise and when appropriate herbal medicine. Rather than focusing on a body part or a symptom in isolation, the skilled practitioner will evaluate and treat any imbalances in the entire body and recognizes the important connection between the physicial and mental/emotional state of the individul. In our program we have found that Chinese medicine and in particular acupuncture can be very effective in addressing a variety of symptoms including chronic pain, fatigue, migraines, irritable bowel syndrome, hormonal imbalances and a variety of other medical symptoms.

Answer: Although it is common for all of these locations to be affected by pain, by definition the pain from fibromyalgia tends to be generalized and not restricted to one location. However, it is certainly common for someone who does have more generalized pain from Fibromyalgia to have specific locations that are more affected at any given time.

Answer: Myofascial Release can be helpful for individuals living with Regional Myofascial Pain syndrome or localized areas of pain related to Fibromyalgia as a component of treatment. When effective, this form of treatment may require some follow up visits. This approach is not meant specifically for patients who are diagnosed with Chronic Fatigue Syndrome, if regional myofascial pain is not present. I rarely see Mofascial Release as a stand alone treatment for Fibromyalgia and would suggest that you consider the more comprehensive approach that is listed on this web site as an option to consider.

Answer: Yes, Reiki and other forms of energy work can be done in conjunction with Acupuncture. Some individuals prefer to work with one approach at a time, but both treatments can complement each other. Reiki is typically done on an individual basis.

Answer: Reiki is a form of energy healing. Some of the practitioners on our team incorporate this and other forms of energy healing as part of a more comprehensive individualized program.

Answer: When we are speaking of treatment for chronic pain and fibromyalgia more specifically there are several drug free options that can be very effective. Although it is always useful to be properly evaluated, in general for chronic pain a comprehensive individualized interdisciplinary approach works best. The Healing Choices web site has many of the therapy options that do work. Irregardless, of whether you choose acupuncture, explore nutritional approaches, massage, chiropractic, physical therapy, etc, a team that supports a positive mental attitude and your intuition as to what will work best for you is critical.

Answer: If a loved one is living with chronic pain, discomfort and fatigue there is often a significant impact on the family. Since this condition is usually hot as physically obvious as other medical conditions, it may make it more difficult for family to truly appreciate what the individual with fibromyalgia is experiencing. In addition to the emotional impact on the family, there may also be a change in the role that the individual plays when it comes to work and household responsibilities. The program of treatment and rehabilitation must consider this reality to be most effective. For most of us, our families are our biggest support. Both the family and the patient need an opportunity through education to fully dispel some of the myths about what fibromyalgia is and what options can make a big difference. To be most effective the patient and the family need to be supported in this process.

Answer: Most health insurance cover the medical evaluation and follow up visits as well as Chiropractice treatment we offer. Although each individual would need to check their own policies for coverage. Since we focus on drug free options, some of the therapy may not be covered. Services like Acupuncture, Massage, Sauna Treatment, and some of the Mind/Body work may not be covered by insurance. However, this may vary depending on the policy.

Answer: The estimated prevalence in the United States of a diagnosis of Fibromyalgia is between 3 to 6 million individuals. Approximately 90% of those diagnosed with Fibromyalgia are woman. I am not aware of a specific breakdown of prevalence by state.

Answer: Although there is some evidence that Fibromyalgia can effect communication within our nervous system and how we perceive or respond to pain and different forms of stimulation, there is no evidence that Fibromyalgia causes nerve damage.

Answer: Although some individuals do describe a sensation of being tremulous, it is unlikely that overt tremors of the lower extremities as the primary symptom is necessarily related to a diagnosis of Fibroyalgia alone. I would advise seeking consultation with your primary care physician or a specialist in the field of neurology for a further evaluation.

Answer: Some individuals do describe some problems expressing themselves when in a flareup or if not getting a sufficient amount of sleep. The non medical term fibro fog has been used to describe some of the cognitive symptoms that individuals living with a diagnosis of Fibromyalgia often face. However, it is critical that other causes for these symptoms get ruled out. In addition, the effects of some medications, chronic pain, chronic insomnia and depression can also contribute to these symtoms and all can be treated.

Answer: Although I can not say for sure without a proper medical evaluation, if the problem is specifically localized to the knuckles it is likely we are looking at something other than Fibromyalgia. We do know that even if you have another painful medical condition such as arthritis, having fibromyalgia can magnify the symptoms of this other diagnosis. I would suggest that you see your physician or appropriate specialist for a formal evaluation.

Answer: Although surgery is generally very effective if done before significant and permanent nerve damage occurs, it is possible for a carpal syndrome to re-occur if the same underlying cause has not changed

Answer: Assuming that we know for sure that the pain in the back and chest is related specifically to a diagnosis of Fibromyalgia, these are common locations. However, if the pain is limited to just those locations and not in other typical parts of the body, then it is unlikely that we are looking at Fibromyalgia as the cause. By definition, Fibromyalgia symptoms generally occur above and below the waist and on both sides of the body, even if there is some asymmetry of symptoms.

Answer: As always it is important to have your physician check out any lumps that you may have. However, it is very common for someone with a diagnosis of Fibromyalgia to describe knots and hard lumps that are very painful and may vary in location. They are often associated with trigger points which certainly can be very painful. Although the underying cause is still uncertain, there are several different strategies and approaches that can be helpful as part of an individualized treatment program with a specialist most familiar with the treatment of Fibromyalgia. Certainly, an appropriate exercise program under the intitial direction of a physical therapist could be helpful with myofascial release being applied when appropriate. Massage therapy with someone famiiar with this condition is also useful. For more localized areas trigger points injection in combination with exercise can be helpful. In my program we also utilize acupuncture, chiropractic, mind/body options and dietary modifications to assist our patients.

Answer: Individuals living with Fibromyalgia often suffer from a variety of symptoms. The most common symptom of course is generalized pain. Fatigue and problems with focus and concencentration are also common symptoms. Since there is often a hypersensitivity to the environment individuals often report extreme sensitivity to heat, cold, odors, chemicals,light, certain foods and to other potential allergens. Given the nature of symptoms depression may also be associated with this condition.

Answer: There is always the potential for any work that requires an activity of a repetitive nature to contribute to a flareup of symptoms in susceptible individuals. Often with some modification of the activity with periods of rest the task could be better tolerated.

Answer: The vast majority of patients with Fibromyalgia do not require a wheelchair or an assistive device to get around. There are some people who do have more difficulties geting around in the community especially at times they are experiencing a flareup and may use a wheelchair. These individuals are in the minority and often have other medical conditions in addition to Fibromyalgia that compounds their disability. The critical point, is that many of the symptoms can be effectively managed with an appropriate indvidualized treatment program.

Answer: Although Fibromyalgia could indirectly affect vision, it is always essential to be evaluated by your medical doctor and have yours eyes examined by a licensed Optometrist or Opthalmologist to rule out a primary eye condition. Certain eye conditions that affect vision can contribute to headaches and can aggravate other Fibromyalgia symptoms if not appropriately treated. We also know that fatigue which is all too common with a diagnosis of Fibromyalgia can further contribute to visual concerns.

Answer: At present there is no definitive blood test for Fibromyalgia. A positive ANA is often used as a screening blood test for Lupus, but by itself is not very specific and needs to be correlated with other lab tests and the patients history and physical exam.

Answer: Although pain can be caused by many different conditions, which should be evaluated by your physician, Fibromyalgia commonly causes pain that is widespread. By definition, generalized leg pain in both legs would be included with symptoms of body pain.

Answer: The services we offer are outlined on this web site. We provide an individualized comprehensive interdisciplinary approach with a focus on non medication options. We also emphasize through both education and support patient empowerment. A thorough review of the medical record and history in conjunction with an initial consultation will also help to determine whether any additional testing is indicated. Although most of the Mind/Body groups are held in the evening we do have the ability to provide 1:1 counselling and support during the day with one of our practitioners. We are available by phone to answer any specific questions about our program and practice.

Answer: By definition arthritis is a collection of conditions that affect the joint specifically with usually some degree of local inflammation. Although both arthritis and fibromyalgia may coexist, they are different conditions. There are many different forms of arthritis with osteoarthritis being the most common. Fibromyalgia is a very different condition, since the the poblem is not with the joints but as best we understand it with the lowered threshold within the nervous system for sensitivity to many different forms of stimulation. This most commonly includes tactile stimulation or touch. Even slight touch or motion can cause a perception of pain throughout the body. Tender points are often present around the tendons and soft tissues throughout the body and could be confused with arthritis because of the close proximity to the joints for some people. Please see the more detailed definition and description of Fibromyalgia on this web site.

Answer: Although pain and discomfort could be more localized ie back and neck, symptoms tend to be more widespread and have to be present for at least 3 months or greater. It sounds as though you need to review this with your physician or specialist for a more complete assessment. The diagnosis of Fibromyalgia is made by both history of generalized total body pain and by tender point exam done by a practitioner familiar with this condition.

Answer: To attempt to summarize the field of Chiropractic medicine in a brief response would not do the field justice. However, chiropractic is a conservative and natural approach to obtaining pain relief, increased range of motion with a focus on the proper balance and alignment of the spine and musculoskeletal system in general. Many practitioner as is the case in our practice also include an emphasis on an appropriate individualized exercise and nutritional program. Although every insurance policy is different, it is generally covered by most health insurance. You would need to check your policy for specific details of coverage.

Answer: Although most people with Fibromalgia are able to work in some capacity, there are some individuals who due to the severity of their symptoms despite best efforts of themselves and their health care team are not able to sustain a consistent work schedule. If you and your doctor feel that you fit into that category a good disability attorney experienced in working with individuals with Fibromyalgia could be very helpful to facilitate the process for you.

Answer: The treatment of chronic pain in general and more specifically for those living with Fibromyalgia is complex. Although there are several medication options, whenever possible getting to the root causes of pain with a careful medical evaluation and when possible a focus on non medication options should be pursued with the assistance of an experienced health care team. Although each person must be approached on a individualized basis, an interdisciplinary approach that includes a focus on diet/lifestyle choices, Mind/Body approaches, proper exercise(if possible use of heated pool), Acupuncture and Massage/Chiropractic can be helpful. It is also critical to normalize sleep. Research has shown that poor sleep can contribute to not only the fatigue but also pain for those suffering with Fibromyalgia.

Answer: A more detailed description of some of the Fibromyalgia symptoms and criteria is included on this website. In addition to pain, fatigue and chronic sleep disturbances are also most commonly seen with this diagnosis.

Answer: Although everyone responds differently, it is not uncommon for the symptoms of Fibromyalgia to affected when GI function not working optimally.

Answer: Although it is not uncommon for individuals with Fibromyalgia to go through periods of remissions and exacerbations, I am not aware of any particular data that outlines the percentage and with what frequency this occurs. This is why I believe that it is important that patients understand that each persons responds on a very individual level to treatment and life situations. There are many factors that contribute to the course of this condition. The course is quite variable.

Answer: Although fibromyalgia may present with symtoms that appear to be neurologic in nature, it sounds as though you may need a more thorough evaluation by a physician to make sure that you do not have any neurologic compromise related to your neck or evidence for a peripheral neuropathy. If not already done this would involve a physical exam and possibly an MRI and/or electrodiagnostic testing. As always this would need to be discussed with your physician or an appropriate specialist.

Answer: In reality each patient will need and respond to an individualized treatment approach. With that said what we have found and this has also been supported by clinical research is an interdisciplinary approach seems to work best. This would include after a thorough medical evaluation, initiation of an appropriate graded exercise program with physical therapy and if available pool therapy. In addition, a formal nutritional/lifestyle assessemnt with initiation of a rotation elimination diet, a full evaluation of sleep and a normalization of the sleep pattern(since this is often problematic with patients suffering from Fibromyalgia with subsequent sleep deprivation), Mind/Body approaches such as Hypnosis by a skilled therapist and other Behavioral Medicine approaches. Acupuncture is also another option that has been helpful in addressing some of the symptoms and minimizing the need for medications. This is not meant to be an exhaustive list, but key areas that can be helpful for many patients.

Answer: No, although Fibromyalgia can be incapacitating for many, it does not pose a direct increased mortality risk.

Answer: Physical trauma and emotional stress could aggravate symtoms of Fibromyalgia for some individuals. However, it is always important to rule out other causes of increased pain or change in symptoms.

Answer: Although it is true that many patients with a diagnosis of Fibromyalgia have an overlaping diagnosis of chronic fatigue syndrome, they in fact have their own separate criteria. Please see my website(home page under common conditions) for more details.

Answer: Although some swelling and sensory changes could be associated with a diagnosis of Fibromyalgia, these symptoms could be indicative of other diagnosis and should be appropriately evaluated by a physician.

Answer: Many important treatments are covered by health insurance. Although since individual policies vary from person to person that will need to be verified by each patient. Unfortunately, some of the treatments that I have found to be most useful are not currently covered. Again this may vary based upon the insurance policy.

Answer: I agree that support of others who are or have experienced what you are going through is very important. Support groups are available throughout the country and allow for more peer support. Obviously, each support group has its own character depending on the leader and members who comprise it. To find out whether there is a support group near your location, you can always contact the state arthritis foundation office. They may have some more details about available groups or resources to offer.

Answer: Fibromyalgia has a significant impact on our society and is costly on many levels. There are approximately 6 million Americans diagnosed with this often debilitating condition. Conservative estimates place direct and indirect costs of Fibromyalgia at $700 million annually. This is represented by time out of work, disability claims, medical costs and impact on the community where these individuals may be playing key roles that are not always able to be fulfilled. The biggest impact however which may not be able to be measured in dollars and cents is the direct personal impact that each individual and their families must endure on a day to day basis living with this diagnosis.

Answer: Although, I am not aware of any treatments that have been proven to cure this condition there are many treatment options that can be very helpful to significantly reduce symptoms, manage flare ups, increase the periods of remission and to improve the overall quality of life and function of individuals living with this condition.

Answer: There is no question that for some people there is a correlation with stress and their fibromyalgia symptoms. That is why the Mind/Body component is such an important part of our program. It is often a viscious cycle of stress with increased pain and in turn in response more tension and stress.

Answer: Although it is unusual(but certainly possible) for someone so young and a male to be diagnosed with fibromyalgia, assuming that this is an accurate diagnosis and all else has been ruled out I would recommend the following- -finding a local pediatric physician who has experience and empathy in working with children with this diagnosis. In addition, it would be helpful to make sure the provider is open to non prescription approaches as well. An approach that includes physical/occupational therapy, nutritional assessment, cognitive behavioral approaches and some of the alternative medicine approaches such as acupuncture could be considered. It is also important to consider with your medical provider the different triggers that may have caused or been associated with the onset of symptoms and those triggers that may exacerbate or ameliorate his present condition. One last thought would be an evaluaton for a chronic sleep disorder which is often associated with fibromyalgia.

Answer: Assuming that you have been correctly diagnosed with fibromyalgia and other conditions have been ruled out, flu like symptoms are a common complaint. Individuals with fibromylagia often feel like they have a case of the flu that does not go away. The increased sensitivity to minimal touch is also commonly seen.

Answer: Although it is true, Fibromyalgia does not have a significant inflammatory component the non steroidal anti-inflammatory medications with proper medical supervision can offer for some patients symptomatic relief. This is true of both the Cox 1 and Cox 2 meds. There is an analgesic effect with this group of medications in addition to the anti inflammatory effect. In addition, some patients with fibromyalgia have other conditions such as tendonitis or certain forms of arthritis which may have an inflammatory component. Since these medications are not without risk, careful review with your medical professional to determine whether use of this group of medications is the best approach for you is critical. There are plenty of other options.

Answer: Most individuals with a diagnosis of Fibromyalgia are able to work. Often job modifications or a change in job is needed to accomodate some of the functional limitations. There are some individuals who despite extensive treatment are unable to sustain regular and consistent work. In that situation they may be eligible for SSDI or private disability insurance. In order meet eligibility it is often helpful to have the assistance of an experienced disability attorney(who has successfully worked with patients with fibromyalgia) and an experienced medical/clinical team who can document the variety of treatments tried and can clearly outline the specific functional limitations that would preclude regular employment even with reasonable modifications. It is important that a thorough evaluation is done by an experienced open minded medical/clinical team to assure that all reasonable treatment options have been explored, since no one approach works for all patients. This is critical not only to address the issue of employment but also because of the significant impact fibromyalgia can have on day to day activities and quality of life.

Answer: We do not know at this time the precise cause of fibromyalgia. However,there is no question that repetitive strain can certainly aggravate the symptoms. A temporary rest from the aggravating activity along with long term ergonomic changes at the worksite with proper medical care is often all that is needed for some individuals to maintain their current job situation. Nevertheless, there are many situations that despite best efforts significant symptoms persist that can be linked to job activities. In those situations a change in job needs to be considered to prevent a further exacerbation of the condition.

Answer: Although weather sensitivity is far from universal, it quite common for individuals with fibromyalgia to give a history of being sensitive to weather changes. Often they act as a human barometer exquisitely aware of most barometric changes. Cold and damp weather is the most common weather related situation that I see that can aggravate symptoms. Nevertheless, since there is a lot of individual variability, I have had patients report to me that the hot weather can be even more of a problem. This is why an individual assessment is so critical.

Answer: Although there has not been a specific gene identified with fibromyalgia, there is a slightly higher assoication of fibromyalgia in families where one of the parents or close relatives has been given this diagnosis. This is important in the sense that it allows family members to have a higher vigilance in their own family in making sure they get a proper diagnosis and treatment quickly. However, most children or close relatives of individuals with a diagnosis of fibromyalgia, never develop this diagnosis.

Answer: There is no question that this is a very frustrating condition. However, there is wide range of presentations of symptoms for individuals diagnosed with Fibromyalgia. For some people it is not uncommon that a partial or even a complete remission can occur with a reoccurence or flare up of symptoms with specific triggers. Some individuals experience the symptoms as chronic, but with symptoms migrating from one area of their body to another. Other individuals have the common experience of the pain starting in one area, perhaps shortly after a physical trauma, but over time the areas of pain generalizes to more areas of the body. In most cases even in that scenario symptoms will usually plateau, unless another medical condition exists to superimpose its own range of symptoms.

Answer: There is no absolute proof that a physical injury is the cause of this condition. However, a physical injury or even significant stress in susceptible individuals could act as a trigger for onset or exacerbation of the Fibromyalgia symptoms.

Answer: There is no evidence to suggest that Fibromyalgia has a direct effect on our vital organs. During periods of major hormonal changes such as menopause, it is not uncommon for some individuals to be faced with additional symptoms. However, by seeking appropriate medical care by a specialist who is familiar with treating fibromyalgia the symptoms should be able to be well controlled.

Answer: At the present time there is no clear evidence that fibromyalgia falls in the same family as Lupus which is an autoimmune disorder. There is however evidence that individuals who are diagnosed with Lupus may present with Fibromyalgia as well. However the two conditions are not the same.