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Fibromyalgia Study

Posted on August 26, 2013 at 11:16 PM Comments comments ()
I am conducting a research survey for my final research. It is focused on people with Fibromyalgia if you or someone you know have been diagnosed with Fibromyalgia please take the survey.
Thank you for your help.

For the survey please click here

Fibromyalgia And Alternative Treatments

Posted on April 14, 2012 at 12:30 PM Comments comments ()
Fibromyalgia and Alternative Treatments
From acupuncture to chiropractic, from massage to meditation, alternative treatments are in great demand. That's especially true for people with pain-related illnesses such as fibromyalgia. Alternative medicine, including herbal therapy and homeopathy, it is used in place of conventional medicine. These systems are based on the belief that the body has the power to heal itself with multiple techniques including those that involve the mind, body and spirit. Complementary medicine is used together with conventional medicine.
For people with fibromyalgia, some alternative treatments work well. That's because holistic therapies influence your total being. In that way, they may allow you to reduce your medications and increase your normal activities.
Study findings show that standard acupuncture may be effective in treating some people with fibromyalgia. Both biofeedback and electroacupuncture have also been used for relief of fibromyalgia symptoms. However, before you try alternative treatments, talk with your doctor. Check to see what limitations might apply to you. Working with your doctor, you can find an acceptable way to blend conventional medicine with alternative treatments or natural remedies. When you do, you may be able to increase restful sleep and reduce your fibromyalgia pain.
Can acupuncture treat fibromyalgia?
With acupuncture, a practitioner inserts one or more dry needles into the skin and underlying tissues at specific points. Gently twisting or otherwise manipulating the needles causes a measurable release of endorphins into the bloodstream. Endorphins are the body's natural opioids. In addition, according to acupuncture practitioners, energy blocks are removed. Removing them is said to restore the flow of energy along the meridians, which are specific energy channels.
Studies show that acupuncture may alter brain chemistry. It appears to do this by changing the release of neurotransmitters. These neurotransmitters stimulate or inhibit nerve impulses in the brain that relay information about external stimuli and sensations such as pain. In this way, the patient's pain tolerance is increased. One acupuncture treatment in some patients may last weeks to help alleviate chronic pain.
What is electroacupuncture?
Electroacupuncture is another way of stimulating the acupuncture points. It uses a needle hooked up to small wires connected to very slight electrical currents. Heat -- moxibustion -- and massage -- acupressure -- can also be used during this electroacupuncture process.
Laser acupuncture is yet another offshoot of this alternative therapy. It may occasionally be effective for the treatment of carpal tunnel syndrome. While it uses the same points, there are no needles involved.
There are precautions to take if you want to try acupuncture. First, make sure you find a licensed acupuncturist who has a lot of experience. Also, make sure the acupuncturist uses only disposable needles.
There are multiple styles of acupuncture. The style used depends on where the practitioner studied. For instance, Chinese acupuncture depends on larger bore needles and the practitioner may be more aggressive with moving them. Japanese acupuncture uses thinner bore needles with a relatively gentle approach. You'll need to find the style that suits your fibromyalgia needs.
How does biofeedback work to ease fibromyalgia? continued...
With biofeedback, you are connected to a machine that informs you and your therapist when you are physically relaxing your body. Sensors detect muscle tension, heart rate, breathing pattern, the amount of sweat produced, or body temperature. Any one or all of these can let the trained biofeedback therapist know if you are learning to relax.
The instruments magnify signals that you might not otherwise notice. As a result, you can use this visual or auditory response to learn how to control certain bodily functions. The ultimate goal of biofeedback is to use this skill outside the therapist's office when you are facing real stressors.
With fibromyalgia pain, you know the "real stressor" is the pain itself. Nevertheless, other daily stressors can cause your fibromyalgia to flare. What you want to do is respond in a healthy way to the chronic stressors. If learned properly, electronic biofeedback can help you control your heart rate, blood pressure, breathing patterns, and muscle tension, potentially reducing pain.
What is homeopathic medicine?
Homeopathy is a therapeutic system of medicine that started in the late 18th century. Homeopathy is based on the principle of "like cures like."  That means that remedies that would cause a potential problem in large doses will actually encourage the body to heal more rapidly if given in small doses. Practitioners use small diluted formulas of plant, mineral, and animal substances to treat various ailments. The hope is these formulas will stimulate the body to throw off the offender.
Can herbal medicine help fibromyalgia?
Herbal remedies have been used for generations. They can be put in tea or soup or taken in other forms. While some herbal therapies have not been shown to have a specific benefit for fibromyalgia symptoms, some patients have found improved sleep or more energy with herbal supplements.
How can meditation help fibromyalgia?
With meditation, you allow your thoughts to take a break from daily analytical routines and give support to the spiritual dimension of life. When you meditate, your body switches from the pumping "fight or flight" response to a calmer, more peaceful mood. Studies show that meditation produces brain waves consistent with serenity and happiness. Meditation provides nourishment for your soul, satiates inner spiritual hunger, and helps you to develop your ability to pay attention to all areas of life without distraction.
What should I remember if I want to try an alternative treatment?
It's important to be openly discriminating when choosing alternative treatments. The fact that something is called "natural" does not mean it is safe. Working with your doctor, look for the alternative therapies that will best boost sleep and decrease pain. The right therapy can help get you on the healthy road again.

Acupuncture and Traditional Chinese Medical Approaches for Fibromyalgia

Posted on February 2, 2012 at 3:32 PM Comments comments ()
Fibromyalgia is a commonly encountered disorder characterized by widespread musculoskeletal pain, stiffness, paresthesia, nonrestorative sleep, and easy fatigability, along with multiple tender points that are widely and symmetrically distributed. Fibromyalgia affects predominantly women in a ratio of 8:1 or 9:1 compared to men. This disorder is found in most countries, in most ethnic groups, and in all types of climates. The prevalence of fibromyalgia in the general population of a community in the United States using the 1990 American College of Rheumatology (ACR) classification criteria was reported to be 3.4 percent in women and 0.5 percent in men. Contrary to some previous reports, fibromyalgia was not found to be present mainly in young women, but rather was most prevalent in women aged 50 years and above. The prevalence increased with age, being 7.4 percent in women between the ages of 70 and 79.
Clinical Manifestations
Symptoms include generalized aching and stiffness of the trunk, hip, and shoulder girdles. Other patients complain of generalized muscle aching and weakness. Patients may complain of low back pain, which may radiate into buttock and legs. Others complain of pain and tightness in the neck and across the upper posterior shoulders. Some patients complain of muscle pain after even mild exertion. Some degree of pain is always present. The pain has been described as burning or gnawing, or as soreness, stiffness or aching. While pain may begin in one region, such as the shoulders, neck, or lower back, it eventually becomes widespread. Patients may complain of joint pain and perceive that their joints are swollen; however, joint examination yields normal findings. Stiffness is usually present upon waking in the morning; usually it improves during the day, but in some patients, it lasts all day. Patients may complain of numbness of the hands and feet. They may also feel colder overall than others in the home, and some may experience Raynaud's-like phenomena or actual Raynaud's phenomenon. Patients complain of feeling fatigued and exhausted, and wake up tired. They also awaken frequently at night and have trouble falling back to sleep. Symptoms are made worse by stress, anxiety, cold, damp weather, and overexertion. Patients often feel better during warmer weather and vacations.
The characteristic feature on physical examination is the demonstration of specific tender points, which are exclusively more tender or painful than adjacent areas. The ACR criteria for fibromyalgia defines 18 tender points (see Figure 1). These points of tenderness are remarkably constant in location. A moderate degree of pressure should be used in digital palpation of these tender points. Some sources recommend that the tender site be palpated using a rolling motion, which may be more effective in eliciting the tenderness. Digital palpation appears to be as effective and accurate for the diagnosis of fibromyalgia as dolorimetry. The amount of pressure applied by the examiner introduces variability in interpretation, however. If too much pressure is applied, the pain will be produced even in normal subjects. Likewise, tenderness will not be appreciated if too little pressure is applied or the site is missed on palpation. Some patients are tender all over and not just at the specific tender point sites. These patients are still more tender over the specific tender point sites; however, sites where there is usually no tenderness and which can be used as controls are the dorsum of the third digit between the proximal interphalangeal and distal interphalangeal joints, the medial third of the clavicle, the medial malleolus, and the forehead.
Skinfold tenderness may be present, particularly over the upper scapular region. Subcutaneous nodules may be felt at sites of tenderness.
Fibromyalgia may be triggered by emotional stress, medical illness, surgery, hypothyroidism, and trauma. It has appeared in some patients with HIV infection, parvovirus B19 infection, or Lyme disease. Disorders commonly associated with fibromyalgia include irritable bowel syndrome, irritable bladder, headaches (including migraine headaches), dysmenorrhea, premenstrual syndrome, restless leg syndrome, temporomandibular joint pain, and Sicca syndrome.
Fibromyalgia is diagnosed by a history of widespread pain and the demonstration of at least 11 of the 18 tender point sites on digital palpation. However, not all patients with fibromyalgia meet these criteria. Some patients have fewer tender sites and more regional pain, and may be considered to have probable fibromyalgia.
Results of joint and muscle examination are normal in fibromyalgia patients, and there are no laboratory abnormalities.
Common Typical TCM Patterns for Fibromyalgia
There are four common typical TCM patterns for fibromyalgia. However, one person may exhibit more than one pattern. The patterns are:
1. Liver Qi Stagnation - anxiety, emotional upset, headaches (including migraine headache), being easily angered, muscle stiffness in neck and shoulders, insomnia, waking frequently and having difficulty falling back to sleep, irritable bowel syndrome. All symptoms may be triggered by emotional stress.

  • Tongue: slightly dusky or slightly puffy
  • Pulse: wiry/bowstring or slippery
  • Treatment plan: smooth liver, move qi and blood
  • Chinese medicine: modifications based on xiao yao wan or shu gan wan
  • Acupuncture points: yin tang, LI 4, LV 3, GB 34, an mian, ren 17, ren 12, ST 25, SP 6, UB 18, 19, and 20
  • Ear points: shen men, liver, sympathetic

2. Qi and Blood Deficiency - specifically spleen qi deficiency and heart blood/liver blood deficiency, with such symptoms as chronic fatigue, exhaustion, dull headache, muscle weakness and numbness, insomnia, dream-disturbed sleep and waking up tired, palpitations and depression.

  • Tongue: pale, with thin white fur
  • Pulse: thready, weak and deep. This pattern eventually creates pattern #3 below.
  • Treatment plan: tonify qi and blood, calm the spirit
  • Chinese medicine: modifications based on ba zhen tang or gui pi tang or gan mai da zao tang
  • Acupuncture points: LI 4, ST 36, ren 12, SP 6, 10, PC 6, HT 6, 7, Kid 3, and UB 17, 20
  • Ear points: adrenal, endocrine, heart, spleen

3. Qi Stagnation and Blood Stasis - aches and pains in the whole body, burning or gnawing pain with tingling sensations in extremities, headaches.

  • Tongue: purple, dusky
  • Pulse: wiry or irregular
  • Treatment plan: move the qi and blood, alleviate pain
  • Chinese medicine: modifications based on shen tong zhu yu tang or tao hong si wu tang
  • Acupuncture points: DU 20, LI 4, 10, ST 36, SP 9, 10, LV 3, PC 6, UB 17, 18
  • Ear points: shen men, adrenal, subcortex.

4. Kidney Deficiency (either Yin, Yang, Qi or Essence Deficiency) - there will be impotence or lack of libido for males and infertility issues for both males and females. Other symptoms: sore lower back with restless leg syndrome, irritable bladder, dysmenorrhea, amenorrhea, premenstrual syndrome, hot flashes and night sweats.

  • Tongue: pale or dry, with cracks
  • Pulse: thin, weak and deep
  • Treatment plan: tonify qi, tonify essence and yang, and nourish yin
  • Chinese medicine: modifications based on you /zuo gui yin (wan), jin gui sheng qi wan, jin suo gu jing wan
  • Acupuncture points: ren 3, 4, 6, LI 11, LV 2, GB 39, Kid 3, 6, 7, SP6, and UB 23, 31
  • Ear points: adrenal, endocrine, kidney

Fibromyalgia doesn't seem to affect the lung so often, as there are few lung symptoms associated with fibromyalgia such as chest tightness, or shortness of breath in a few cases.
Special Points for Fibromyalgia Pain
Integrative medicine, in terms of acupuncture and Chinese medicine combined with Western medicine and other therapies, is very helpful in treating all kinds of pain related to fibromyalgia. As a neuropsychiatrist, I have been continuously working and studying at hospitals in China, as well as at my clinic in United States, for over 20 years. Based on my experiences, I now have a personal conclusion about some special acupuncture points, which are very useful and applicable in fibromyalgia.
Special Acupuncture Points

  1. Ashi points: Use any tender points that the patient has along with any of the following points listed below. There are a total of 18 tender point sites that may present in fibromyalgia, which are located in Figure 1. Note that the points are in groups of three, so they are referred to as "three points" along with the body area's name (for example, "the three arm points").
  2. Headache (includes migraines): For frontal/temple headache, GB 14, tai yang and yin tang or er zhong (above yin tang, in line with GB14). For vertex headache: Du 20 and si shen cong. You can do a variation of si shen cong by putting the needles 1.5 cun out from Du 20 (si shen cong is 1 cun out from DU 20). Occipital headache: UB10, DU17 and GB20.
  3. Neck pain: UB 11, GB 20 and bai lao.
  4. Shoulder pain: LI 15, and two experienced points: point A, 2 cun anterior to LI 15 under the clavicle, and point B, 2 cun posterior to LI 15 on the back (half way between SJ 14 and LI 16).
  5. Arm pain: LI 11, SJ 5 and LI 4.
  6. Upper back pain: UB 11, UB 17, SI 12
  7. Lower back pain: UB 23, UB 25 and UB 52
  8. Leg pain: ST 36, SP 6, GB 30
  9. Thigh pain: SP 10, SP 11/ST 31 and ST 32
  10. For any tight muscle: release the muscle with three needles - one at each insertion and one in the middle of the muscle.

Acupuncture and Chinese medicine provide relief of symptoms by balancing yin and yang, and adjusting the circulation of qi and the blood. Local measures such as heat, therapeutic massage, cupping, moxibustion and gua sha in specific regions also help to reduce the pain. A regular plan, with long-term, consistent integrative treatment is necessary in patients with fibromyalgia.

  • Harrison's Principles of Internal Medicine, 16 edition.

Page printed from:

Pain Treatment of Fibromyalgia by Acupuncture

Posted on November 3, 2011 at 10:27 PM Comments comments ()
Abstract The lack of objective parameters makes the
measurement of pain and the efficacy of pain treatment in
patients with chronic pain very difficult. We performed acupuncture
therapy in fibromyalgia patients and established
a combination of methods to objectify pain measurement
before and after therapy. The parameters corresponded to
patients’ self-report. Twenty-nine fibromyalgia patients as
defined by ACR-criteria (25 women, 4 men) with a mean
age of 48.2±2.0 years and a mean disease duration of
6.1±1.0 years participated in the study. Pain levels and positive
tender points were assessed using the visual analogue
scale (VAS, i.e., range 0–100 mm) and dolorimetry. Serotonin
and substance P levels in serum and the serotonin concentration
in platelets were measured concomitantly. During
acupuncture therapy no analgesic medication was allowed.
The VAS scores decreased from 64.0±3.4 mm before
therapy to 34.5±4.3 mm after therapy (P<0.001). Dolorimetry
revealed a decreased number of tender points after
therapy from 16.0±0.6 to 11.8±1.0, P<0.01. Serotonin
levels decreased from 715.8±225.8 μg/1012 platelets
to 352.4±47.9 μg/1012 platelets (P<0.01), whereas the
serum concentration increased from 134.0±14.3 ng/ml
to 171.2±14.6 ng/ml (P<0.01). Substance P levels in
serum increased from 43.4±3.5 pg/ml to 66.9±8.8 pg/ml
(P<0.01). Acupuncture treatment of patients with fibromyalgia
was associated with decreased pain levels and
fewer positive tender points as measured by VAS and dolorimetry.
This was accompanied by decreased serotonin
concentration in platelets and an increase of serotonin and
substance P levels in serum. These results suggest that
acupuncture therapy is associated with changes in the concentrations
of pain-modulating substances in serum. The
preliminary results are objective parameters for acupuncture
efficacy in patients with fibromyalgia.
Key words Fibromyalgia · Serotonin · Substance P ·
Pain · Acupuncture · Therapy
Fibromyalgia is characterised by widespread pain [1]. In
addition to the phenomenon of pain [1–4], researchers have
shown pathological changes in pain-modulating substances
in fibromyalgia patients [5–8]. Acupuncture therapy
effectively reduces pain in fibromyalgia patients as
previously shown [9]. The relationship between pain reduction
and changes in pain-modulating substances in
serum after acupuncture, however, is currently unknown.
The aims of this study are to examine whether pain reduction
after acupuncture treatment is concomitantly related
to changes in serotonin and substance P levels and to
make the efficacy of acupuncture treatment more objective.
Twenty-nine fibromyalgia patients (25 women, 4 men)
with a mean age of 48.2±2.0 years and mean duration of
symptoms of 6.1±1.0 years were treated with acupuncture
over 6 weeks (6 single treatments, once per week) according
to an individually adapted therapy strategy following
acupuncture rules [9]. The population did not show any alcohol
or nicotine abuse in their history. No pain medication
was allowed during the study. The following parameters
were investigated to characterise the effect of the treatment:
– Patients reported their pain levels before and after acupuncture
treatment using the 100 mm visual analogue
scale (VAS) (0 mm = no pain; 100 mm = most intensive
– Dolorimetry with a commercial dolorimeter (markasub,
Basel, Switzerland) of 24 tender points as recommended
by Lautenschläger et al. [10]
Received: 15 May 1997
H. Sprott · S. Franke · H. Kluge · G. Hein
Pain treatment of fibromyalgia by acupuncture
Rheumatol Int (1998) 18: 35–36 © Springer-Verlag 1998
Dr. H. Sprott (½) · S. Franke · G. Hein
Department of Internal Medicine IV, Friedrich Schiller University,
D-07740 Jena, Germany
Tel.: +3641-939-157
Fax: +3641-939-269,
H. Kluge
Department of Neurology, Friedrich Schiller University,
Jena, Germany
– Measurement of platelet serotonin by fluorescent complex
formation between serotonin and o-phthaldialdehyde
– Measurement of serum serotonin by a commercial competitive
ELISA (Amicyl-Test, IBL, Hamburg, Germany)
– Measurement of the serum substance P concentration in
serum after purification of the specimens on C-18-RPcolumns
(Sep-Pak Plus C 18 columns, Millipore Waters,
Eschborn, Germany) by an ELISA system (Cayman
Chemical Company Ann Arbor MI, USA)
Statistical analyses were performed by SPSS for
WINDOWS. Means and S.E.M. are reported. The Wilcoxon
rank sum test was used.
All parameters measured before and after acupuncture
therapy are shown in Table 1. As shown, there was a statistically
significant decrease in the number of pathological
tender points and in patients’ VAS scores. There was
also a significant decrease in platelet serotonin, an increase
in the serum serotonin concentration, and a significant increase
in the substance P level.
The significant pain reduction shown in the VAS and as
assessed by dolorimetry suggest that acupuncture is a satisfactory
adjuvant pain treatment in patients with fibromyalgia.
The aim of the current study was to examine
the concentrations of the so-called pain-modulating substances
such as serotonin and substance P which are low
in the serum of fibromyalgia patients [8] before and after
acupuncture treatment. The results show that there is an
increase to levels observed in healthy individuals [12] after
acupuncture treatment. The platelet serotonin concentration
decreases, corresponding to a double increase of the
free serum serotonin based on a mean number of 210 platelets/
ml plasma. This suggests that the normalisation of the
serum serotonin level is due to a mobilisation of platelet
serotonin. These findings suggest that acupuncture is associated
with a change in serotonin and substance P in
serum in patients with fibromyalgia. In addition we observed
reductions in the number of pathological tender
points and decreased VAS scores corresponding to
patients’ own reports of pain reduction. There is a need for
further randomised and controlled studies to confirm these
preliminary results.
1. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C,
Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P,
Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter RA,
Hamaty D, Lessard L, Lichtbroun AS, Masi AT, McCain GA,
Reynolds WJ, Romano TJ, Russell IJ, Sheon RP (1990) The
American College of Rheumatology 1990 criteria for the classification
of fibromyalgia. Report of the Multicenter Criteria
Committee. Arthritis Rheum 33:160–172
2. Müller W, Lautenschläger J (1990) Die generalisierte Tendomyopathie
(GTM) I: Klinik, Verlauf und Differentialdiagnose.
Z Rheumatol 49:11–21
3. Müller W, Lautenschläger J (1990) Die generalisierte Tendomyopathie
(GTM) II: Pathogenese und Therapie. Z Rheumatol
4. Brückle W, Müller W (1991) Schmerzverlauf und -topographie
gei generalisierten Tendomyopathien. Z Rheumatol 50 [Suppl 1]:
5. Russell IJ, Orr MD, Littman B, Vipraio GA, Alboukrek D, Michalek
JE, Lopez Y, MacKillip F (1994) Elevated cerebrospinal
fluid levels of substance P in patients with the fibromyalgia syndrome.
Arthritis Rheum 37:1593–1601
6. Sprott H, Kluge H, Franke S, Hein G (1995) Altered serotoninlevels
in patients with fibromyalgia. J Musculoske Pain 3
[Suppl 1]:65
7. Sprott H, Franke S, Grohmann G, Kluge H, Hein G (1995) Pathologische
Befunde bei Patienten mit generalisierter Tendomyopathie
(Fibromyalgie). Z Rheumatol 54:342
8. Stratz T, Schochat T, Farber L, Schweiger C, Müller W (1995)
Are there subgroups in Fibromyalgia? J Musculoske Pain 3
[Suppl 1]:15
9. Sprott H (1998) Efficiency of acupuncture in patients with fibromyalgia.
Clin Bull Myofascial Therapy 3 (in press)
10. Lautenschläger J, Brückle W, Müller W (1991) Untersuchungen
über druckschmerzhafte Punkte bei Patienten mit generalisierter
Tendomyopathie. In: Müller W (ed) Generalisierte Tendomyopathie
(Fibromyalgie). Steinkopff, Darmstadt, p 105
11. Bailly D, Vignau J, Lauth B, Racadat N, Benscart R, Servant D,
Parquet PJ (1990) Platelet serotonin decrease in alcoholic patients.
Acta Psychiatr Scand 81:68–72
12. Stratz T, Schochat T, Hrycaj P, Schweiger C, Mennet P, Färber
L, Müller W (1995) The blockade of 5-HT3-receptors in fibromyalgia
– a new therapy concept? J Musculoske Pain 3
[Suppl 1]:64
Table 1 All evaluated parameters before and after acupuncture
treatment (means±SEM are given)
Before therapy After therapy Significance
VAS (mm) 64.0±3.4 34.5±4.3 P<0.001
Tender points (n) 16.0±0.6 11.8±1.0 P<0.01
Serotonin 715.8±225.8 352.4±47.9 P<0.01
(μg/1012 platelets)
Serotonin in serum 134.0±14.3 171.2±14.6 P<0.01
Substance P in serum 43.4±3.5 66.9±8.8 P<0.01

Study: Acupuncture Improves Symptoms of Fibromyalgia

Posted on May 12, 2011 at 6:53 PM Comments comments ()
Small Trial Finds Short-Term Benefits for Pain, Fatigue and Anxiety
The National Institutes of Health estimates that between 3 percent and 6 percent of all Americans sufferfrom fibromyalgia. A chronic disorder characterized by widespread musculoskeletal pain, fatigue, andtenderness in localized areas of the body called "tender points," fibromyalgia primarily occurs in women,although it can strike people of both sexes and all ages. The pain associated with fibromyalgia oftenfluctuates in duration and intensity. At times, it can be quite mild; on other occasions, the pain can be sosevere as to affect a person’s ability to carry out normal functions of daily living.Just as fibromyalgia has no known cause, there is also no known cure. The medicalmanagement of fibromyalgia usually consists of a combination of approaches, including stress counseling,exercise, and a class of antidepressants known as tricyclics. These methods are considered only partiallyeffective, however, and can sometimes cause side-effects, such as excessive drowsiness, weight gain andconstipation.One form of care being used increasingly to treat the symptoms associated with fibromyalgia isacupuncture, although the current evidence supporting acupuncture in the treatment of fibromyalgia appearsmixed. The 1997 NIH Consensus Statement on Acupuncture, for example, cited fibromyalgia as one of dozens of conditions for which acupuncture could be "useful as an adjunct treatment or an acceptable- 1 -alternative or be included in a comprehensive management program." 1 Studies published in 1998 and2000 2,3 concluded that acupuncture could reduce pain levels and be effective in treating fibromyalgia, while a randomized clinical trial published in July 2005 suggested true acupuncture was no better than a shamtreatment in relieving fibromyalgia pain. 4One of the most recent investigations into the effectiveness of acupuncture for fibromyalgia was presentedat the 11th World Congress on Pain in Sydney, Australia in August, 2005. 5 The trial, conducted by researchers at the Mayo Clinic, found that acupuncture provided significant improvements in a variety ofsymptoms associated with fibromyalgia, with the effects of care often lasting several months."This study shows there is something real about acupuncture and its effects on fibromyalgia," said Dr.David Martin, the study’s lead investigator, in a news conference held during the congress. "Our study wasperformed on patients with moderate to severe fibromyalgia. It’s my speculation that if acupuncture worksfor these patients with recalcitrant fibromyalgia - where previous treatments had not provided satisfactoryrelief - it would likely work for many of the millions of fibromyalgia patients." 6The study included 50 patients who met the American College of Rheumatology’s criteria for fibromyalgia,and who had tried other conservative treatments for relief, without success. The patients were then randomlyassigned to receive either acupuncture or simulated acupuncture, but were not told which treatment theyreceived. Acupuncture was administered for a total of six sessions over a two- to three-week period;simulated acupuncture was delivered during the same time frame.Before the first treatment, immediately after the last treatment, and at one- and seven-month periodsthereafter, patients filled out a series of questionnaires to determine the degree of symptoms theyexperienced, the effect fibromyalgia had on their daily lives, and the effects of acupuncture on relieving thecondition.According to the study authors, "Fibromyalgia symptoms were significantly improved in the acupuncturegroup as compared to the control group over the study benefit," with the greatest improvement occurring atone month following the last treatment. While activity and physical function levels did not change betweengroups, significant benefits were seen in patients who received acupuncture when comparing questionnairescores for pain, anxiety and fatigue.- 2 -"We expected the acupuncture to improve the pain," Dr. Martin said. "We didn’t really expect the largestbenefit to be in fatigue or anxiety."By seven months post-treatment, the symptoms of pain, anxiety and fatigue experienced by the acupuncturepatients had returned to baseline levels. Martin indicated his belief that the patients given acupuncturewould have seen sustained improvement in their symptoms had they continued to receive care."It’s a reasonable expectation that if they received more acupuncture after two to three months, they wouldhave maintained their improvement," he said. "Acupuncture usually works for about three months, and thenpatients need a less intensive treatment session. These patients would need more acupuncture periodicallyfor as long as they experience fibromyalgia symptoms."Recognizing and treating fibromyalgia can be a challenge for both patients and health care providers. Whileacupuncture may not cure fibromyalgia, the researchers believe that at the very least, it can fill a gap interms of the number of therapies that can help relieve the symptoms of the condition, either as a standaloneform of care or as an adjunct to other therapies."There’s not a cure available, so patients are often left somewhat frustrated by continuing pain and fatigue,"Martin explained. "Acupuncture is one of the few things shown to be effective for these symptoms. It maybe particularly attractive to patients who are unable to take medications because of intolerable side-effects."References1. Acupuncture . National Institutes of Health Consensus Development Statement, Nov. 3-5, 1997. In press.2. Sprott H, Franke S, Kluge H, et al. Pain treatment of fibromyalgia by acupuncture. Rheumatol Int1998;18(1):35-6.3. Berman BM, Swyers JP, Ezzo J. The evidence for acupuncture as a treatment for rheumatologicconditions. Rheum Dis Clin North Am Feb 2000;26(1):103-15, ix-x. 4. Assefi NP, Sherman KJ, Jacobsen C, et al. A randomized clinical trial of acupuncture compared withsham acupuncture in fibromyalgia. Ann Intern Med July 5, 2005;143(1):10-9. 5. Martin DP, Sletten CD, Williams BA, et al. Acupuncture Improves Symptoms of Fibromyalgia: ARandomized, Controlled Trial. Abstract #1260-P130. Presented at the 11th World Congress on Pain,Sydney, Australia, Aug. 25, 2005. Available from the International Association for the Study of Pain- 3 -(; Tel: 206-547-6409).6. Acupuncture relives symptoms of fibromyalgia. Newswise Medical News press release, Aug. 25, 2005.Available online at printed from: 4