Cure your Fibromyalgia

Let’s put to the side the past stigmas associated with Fibromyalgia. For many years a majority of physicians did not believe in Fibromyalgia and there are still a few physicians who refuse to recognize or treat Fibro patients.  While rounding on patients in the hospital, I have overhead a colleague label Fibromyalgia as the “depressed, overweight, middle age, housewife syndrome”.
Luckily, the medical community is finally coming around to recognizing this chronic pain condition.  Current Fibromyalgia research and treatment philosophy resolves around the theory of Fibromyalgia being a  mixed component of a central nervous system dysfunction with a chronic myofascial component.
Fibromyalgia is a diagnosis of exclusion, make sure to have labs to rule our other connective tissues diseases first, like Rheumatoid Arthritis, before accepting the Fibro diagnosis.

Below is a list of recommendations we make to all of our Fibromyalgia patients on there first visit:

  1. Every Fibro patients needs a sleep study to treat any underlying sleep disorders that will directly complicate pain.
  2. Treat any underlying depression, this can not be understated!  Whether with counseling, psychiatric treatment, meditation and if needed medication
  3. Check underlying vitamin deficiencies that can complicate pain, including Vitamin D, Vitamin B12, Vitamin B1, Vitamin B2 and Vitamin B6.
  4. Start a daily home exercise/stretching program, Fibro will worsens with inactivity.  We have heard every argument from patients that it hurts to much to exercise but it is critical to do some daily stretching/exercise routine.  We recommend low impact yoga, pilates, tai chi, aquatic therapy.
  5. Eliminate all soda’s immediately, totally toxic and can increase inflammatory levels in the body complicating pain.
  6. Restrict the ‘nightshade plants’ from the diet to limit their inflammatory related issues.
  7. Limit yeast foods, so many of our patients struggle with this one but it will dramatically improve your energy
  8. Work with a local physician and consider one of the FDA approved medications for Fibromyalgia: Cymbalta, Lyrica or Savella.
  9. Consider a workup for gluten allergy.

Cure your pain: Migraine Treatment

Patients who suffer from Migraine Headaches are often a perplexing challenge for healthcare providers.  Headaches lead to a startling level of disability, decreased productivity and missed days from work.  Treating Migraine Headaches is a challenge as there isn’t one treatment that works for all patients.  The good news for Migraine sufferers, there has been tremendous strides in the research and treatment options.

First, everyone with new onset of Headaches needs to  have a formal initial workup by a neurologist to diagnose their headache.  After the diagnosis of Migraine is made, either a neurologist or a combination of a neurologist and an interventional pain specialist can treat the symptoms.

A traditional first line of treatment is to identify any triggers.  There is a range of initial medications used from abortive medications if patients have only a few Migraines per month, to preventive medications if patients have greater than 6 Migraines per month.

There are a few interventional procedures for Migraine treatment that can be quite successful for the treatment of Migraines.  Botox for Migraine can be performed every 3 months to decrease the frequency and intensity of headaches.  An interventional treatment, performed only by interventional pain specialists, is a Sphenopalatine Ganglion Block.  We have found SPG blocks specifically effective for Migraine Headaches, atypical facial pain and cluster headaches.

When treating any type of headache it is also very important to treat any underlying anxiety and depression related issues that can complicate treatment.

You may not like to hear this, but we DO NOT treat headaches with narcotic medication.  We especially avoid using daily narcotic medications for Migraines as it will lead to rebound headache phenomenon.  We also require our headache patients to eliminate nicotine, caffeine and all sodas from their regimen.

A few helpful supplements for headache patients include:  Magnesium, Coq10 and Vitamin B2. We also recommend mindfulness apps like Headspace and Stop Breathe Think to help with headache management.

There is exciting news in the treatment of Migraines as a new pathway for the treatment of Migraines will have options on the market later this year.  Medication focused on the calcitonin gene-related peptide (CGRP) will be yet another tool in the treatment box for patients.

If you suffer from Migraine headaches and have not tried all the treatments above seek help and don’t give up.  There is a cure for your headaches!