Some of the more difficult syndromes for Western medicine to address are those which involve chronic pain in the muscles, tendons and joints. A wide range of disorders can be reponsible for these symptoms, and so it is usually necessary to look for a variety of underlying disorders. In recent years, several syndromes with poor sleeping, muscle pain and fatigue have been labeled "fibromyalgia" or "chronic fatigue syndrome".
Such disorders can be independent of connective tissue disease, or associated with such problems as lupus erythematosis, rheumatoid arthritis, osteoarthritis, or mixed connective tissue disease. It can be very difficult to make a diagnosis when laboratory or physical symptoms are unclear.
A wide variety of symptoms has been associated with the fibromyalgia and chronic fatigue syndromes, and symptoms can vary according to season or time of day. Some patients note that rather than fatigue, they have such poor stamina that they cannot complete simple tasks without exhaustion.
Others feel they are tired all the time and complain of weakness or lack of strength. It is common to also have fibromyalgia or chronic fatigue along with psychological complaints of depression, anxiety, poor concentration, "spaciness" or "brain fog". Alarming physical symptoms such as palpitations, heaviness in the chest, or difficulty breathing are also seen, and are often the reason that patients seek medical care.
Sometimes pain and fatigue are not always present, and increased muscular pain and fatigue develop after exercise or unaccustomed levels of activity. Fatigue can also be associated with increased muscular pain or joint pain for any reason. So, these syndromes overlap considerably; a diagnosis of fibromyalgia, fibrositis, or findings of many tender trigger points in the muscles is common in people with excessive fatigue.
There has been no proven treatment for these syndromes,and I have found that individualizing treatment is usually the best approach. Often associated with fibromyalgia and fatigue is a sleep disorder, and when the cause of frequent awakenings or disturbed sleep is addressed, the fatigue and fibromyalgia improves.
Of course, if there are endocrine or autoimmune disorders, it may be necessary to treat these. Because Western medical training emphasizes compartmentalizing different body functions, it is common for patients to have seen an internist, a psychiatrist, a rheumatologist, or other specialist, alone or together before a diagnosis is made. In practice it is very difficult to coordinate care with so many practitioners. Physicians may also diagnose chronic fatigue using different names, such as asthenia, myasthenia or neurasthenia. Depression may also manifest with pain and sleep disorders, leading to secondary chronic fatigue or fibromyalgia.
The approach of traditional Chinese medicine to chronic fatigue and fibromyalgia requires that a specific diagnosis be made regarding the pattern of the imbalance. Here again, several types of problems can contribute to fatigue and muscle pain, and the best way to determine your particular imbalance is to consult a physician familiar with all aspects of Chinese medicine. Usually, a complete evaluation from a Western perspective is useful to rule out any of the many biochemical or hormonal problems which can contribute to chronic fatigue or fibromyalgia.
Western approaches tend to emphasize the use of stimulants or antidepressant medications. Often, these cause considerable side effects, and patients complain that they still don't feel "right". Acupuncture therapy, moxabustion, and traditional Chinese medicine prepared from different herbs, roots, and barks, are effective in helping many complex physical disorders like chronic fatigue, arthritis and fibromyalgia without the side effects and risks of drug therapy.
Treating chronic fatigue or fibromyalgia with acupuncture and herbal medicine usually takes time. Chinese doctors have a saying that it takes a month of treatment to address a year of illness. You should expect that at least three months of treatment would be necessary before you can tell how you are responding to Oriental medicine. You may also have to change your diet and exercise habits. As with many chronic disorders, treatment may be ongoing and a relapse of fatigue or fibromyalgia may occur if patients discontinue treatment.
Time will prove that traditional methods of treatment like acupuncture and Chinese herbal medicine will help to reduce both medical cost and suffering for modern patients and difficult to treat conditions.
Dr. L.B. Grotte, M.D., was the first physician in Ohio to be board certified in both acupuncture and Chinese herbology. He has studied Oriental medicine since 1972 and has practiced Chinese medicine in Cleveland for more than 27 years. Our small practice specializes in creating individualized treatment plans combining Western and Oriental methods. Call us at 440-461-7488 to make an appointment or visit our website for more information.