Dr. Whittaker's Blog

I just gave a presentation on fibromyalgia. So I thought I’d share some of the principles with the rest of the world. If you or a loved one is suffering from fibromyalgia, I don’t need to tell you how debilitating it can be. It’s a difficult condition to diagnose, probably due to a lack of definitive tests. Doctors who are looking for it see it frequently, whereas more conservative doctors may not even believe in it and would therefore never offer that as a diagnosis. Used to be, people who had it were generally told it was all in their head. Some people may still be told that from time to time since it’s so hard to prove.

One of the possible causes of fibromyalgia is depression. It will also trigger a flare-up and it’s also listed as a complication of fibromyalgia. So which comes first – depression or fibromyalgia? I’m sure it varies from person to person. One thing for sure, if you hurt every day and can’t do the normal things in life without difficulty, especially when there’s no obvious reason for it, chances are you will get depressed, if you weren’t already! It’s not all in your head, but it can at least partly stem from where your head is at.

The problem is that fibromyalgia isn’t really a specific disease. I refer to it simply as a condition. There are two main criteria for diagnosing it. First, you have to have widespread pain in all four quadrants of the body for a minimum duration of three months. Second, you have tenderness or pain in at least 11 of the 18 specified tender points when pressure is applied. For more information, visit the National Fibromyalgia Association’s website at www.fmaware.org.

I’ve gathered a list of possible causes of fibromyalgia from a number of sources:

• Immune system problems
• Physically unfit muscles 
• Disturbance in brain chemistry
• Sleep Disturbances or Insomnia
• Infection with the Epstein-Barr virus
• Food allergy
• Emotional stress
• Intestinal candida overgrowth
• Nutritional deficiencies
• Adrenal exhaustion
• Chronic mercury poisoning from amalgam dental fillings
• Anemia
• Hypoglycemia 
• Hypothyroidism
• Fibromyalgia is closely related to chronic fatigue syndrome (CFS), which causes similar symptoms, except that in fibromyalgia, muscle pain predominates over fatigue, whereas in CFS, fatigue predominates over pain.
• Muscular hypoxia

It’s that last one that I’d like to focus on. I’ve seen some interesting research that may provide hope. It has to do with ATP production. ATP is the substance that your body produces for managing and storing energy. It’s been found that fibromyalgia sufferers frequently have low levels of ATP in their blood platelets. Two nutrients that help to boost ATP production are magnesium and malate (or malic acid). One study showed that patients taking 300-600 mg of magnesium and 1200-2400 mg of malic acid per day showed an average 60% reduction in pain after only 48 hours.

Here are a few other things you can do to improve this condition:

• Exercise — Fibromyalgia can be a downward spiral. The muscles desperately need exercise, but it hurts to exercise and can cause a flare-up that can last for days. Without the stretching, increased circulation and movement in the muscles, fibromyalgia symptoms will gradually increase. Exercise is an important component of the management of this condition. The keys are to start off very slowly and to make the exercise regimen part of an entire management program (see the other suggestions listed in this blog). I recommend starting off with walking and stretching.
• Omega-3 fatty acids — Irritation leads to inflammation, which can cause more irritation (another one of those ugly spirals). Omega-3 essential fatty acids (EPA, DHA) naturally reduces inflammation.
• Chiropractic — Regular chiropractic adjustments will improve both mobility and function. It will also increase your general health and well-being.
• Stress/emotion management — Find reasons to laugh, let go of stress. Emotional stress can kick off fibromyalgia flare-ups and is even suggested as one of the causes. As much as possible, avoid negative physical, emotional, chemical and nutritional stress. I realize that’s a very broad statement, but in this context, that’s about as deep as I can go on that. As much as you can follow a proper path of health and reduce stresses upon your system, the less pain you will experience.

Try these things. Hope is an essential ingredient in the management of any condition or disease. Do what you can to take control. Giving up, giving in only empowers the problem more than the solution.

I recently had a patient come in with severe neurological damage. Several years ago, she was undergoing medical treatment for migraine headaches. The doctor was injecting her neck with steroids. The first shot was okay, but the second one went terribly wrong. He apparently went in too far, injecting into her spinal cord. She was paralyzed for six months. She eventually got to where she could walk and get around fairly well. However, it left her right hand and arm practically useless. She is in constant pain and must use implanted electrodes along her spine to try to control the symptoms, as well as taking strong pain killers every day. In spite of all that, the pain and disability are almost unbearable. This has been going on for six years now.

The purpose of this blog is not to criticize the medical treatment this woman received. The outcome was obviously tragic. I frankly don’t know enough about the circumstances or what the doctor was doing to comment on it intelligently. What really bothers me is that I have successfully treated many migraine patients through gentle and natural means without ever harming anyone. Perhaps I could have averted this tragedy if this woman would have come to see me or one of many other chiropractors who have similar techniques.

Chiropractic is safe and works in harmony with the body. Serious adverse effects are extremely rare. In fact, in 26 years of practice, I’ve never seen any. Effectiveness, of course, varies from person to person. With some people it helps a great deal, while a few not so much. I wish I could say that I’ve totally eliminated everyone’s headaches that’s ever been to see me. However, at least 90% of them have had their headaches, including migraines, significantly reduced or eliminated. (I know — that’s not very statistical; it’s just an observation. But it is an honest assessment of my experience.)

I hope that people with chronic headaches will give chiropractic a try. I realize that medications are easier and cheaper, but they do have side effects and dangers, and they do nothing to address the underlying cause.

This is not actually about a battle that is inflammatory. This is about the battle against inflammation itself. Inflammation, which is an immune response, creates pain, stiffness and decreased function in joints, muscles and other parts of your body. Inflammation reduces proper flow of blood and lymph, thus allowing toxins to build up in that area. This swelling results from injury, infection or just irritation of soft tissues and can slow the healing process.

The most common approach to treatment of inflammation is with nonsteroidal anti-inflammatory drugs (NSAIDs). More than 70 million prescriptions are written for NSAIDs each year and 30 BILLION over-the-counter tablets are sold annually. This represents a 9 billion dollar annual industry in the United States alone.

So what’s wrong with using NSAIDs? Their use has been associated with gastric ulcers, bleeding, myocardial infarction, stroke and even death. Prescription NSAIDs for rheumatoid and osteoarthritis alone cause over 16,000 deaths each year. NSAIDs are actually the most common cause of drug-related mortality reported to the FDA and other regulatory agencies around the world.

Are you taking NSAIDs? You may not know them by that name. We see them as aspirin, ibuprofen, naproxin and other terms. There are safer and healthier alternatives! For localized relief, an ice pack can be very effective. Ice should only be used when there are no serious circulatory problems. Also, don’t put it directly on the skin. Use a thin towel or something similar to protect the skin. Place the ice pack on the area of inflammation for 10-20 minutes.

For longer term treatment, omega-3 fish oil can help to control inflammation. Essential fatty acids in the fish oil can help reduce joint pain, including pain from arthritis. Most of the greasy foods that people eat, including potato chips, french fries and many processed foods are high in omega-6 fatty acids, which can increase inflammation in the body. Eating too much red meat can also contribute to the inflammatory process.

Much has been studied and written about the harmful effects of inflammatory processes within the body. It goes beyond simple pain. However, I won’t try to address that issue in this brief post. How do you know if there’s inflammation if it’s not all red and swollen? When it comes to joints and muscles, if it hurts, there’s usually inflammation. What about treating it with heat? Heat is good for stiffness. Alternating heat and cold can even be an effective method of treating mild inflammation and driving out toxins. However, heat pulls fluids in, which can increase inflammation. That’s why I always tell my patients — if in doubt, use ice.

The most common headache is a tension headache. Just about everyone gets one from time to time. It usually starts out mildly with a little tension in the neck, shoulders and back of the head. The tension leads to pain. The pain creates more tension. And so it escalates in a vicious cycle. To relieve the resultant headache, the cycle must be broken. Most people will take a pain reliever. If the pain can be reduced and the source of the tension is not continuing unabated, the headache will usually go away.

For occasional headaches, this method of treatment works well for most people. There are two main problems with it though. First, medication works with varying effectiveness and carries with it risks and side effects. Secondly, the cause of the headache was not addressed. Sometimes the cause is obvious, such as a horribly stressful day or a poor night’s sleep. Other times it’s not so obvious. Headaches may be coming back for no apparent reason. When that is the case, don’t just ignore it and take more pain pills. See a professional and find the cause. Sometimes it’s something simple that can be taken care of, in which case you don’t want to just go through life covering it up. In some cases, the headaches are a sign of something more ominous that needs attention. In all cases, if a severe headache comes on suddenly, especially if there are any neurological symptoms accompanying it, seek medical attention immediately.

A common source of chronic headaches that I see in my practice is vertebral subluxations (small misalignments) in the neck. Through a series of chiropractic adjustments, these subluxations can be corrected. When we do so, we find in most cases that the headaches are eliminated or significantly reduced. I’ve had many patients tell me that the quality of their life has vastly improved by bringing the headaches under control. There are often other factors that we look at also. We want to eliminate as many of the causal factors as we can for the overall health of the patient. As far as the headaches go, it’s often a matter of reducing the problems to the point that the body can deal with them better and then the headaches go away or occur with less frequency and severity.

Whenever an occasional tension headache does come on, here are a few things you can do to help relieve it:

• Tension headache pain often comes from the muscle attachments on the occiput (base of the skull at the back of the head). Applying mild pressure with your fingertips on the painful points on the occiput, especially with a little upward pull, helps to relieve that pain at those muscle attachments.
• Ice will also help to soothe the muscles and drive out inflammation from irritated muscles and joints. (Heat can be very relaxing, but should only be used when you’re certain there is no inflammation.) An effective method of icing the neck is to roll up a small towel and lay a soft ice pack or bag of crushed ice over the towel. Then put a towel or cloth napkin over the ice. (You should not have the ice pack right against your skin.) Lay on your back with this ice pack arrangement under your neck for 10-15 minutes. (Do not use ice if you have circulation problems or are overly sensitive to cold.)
• Take several slow, deep breaths. When we get stressed, our breathing often becomes shallow and erratic. Deep breathing helps your body to relax, gives you a bit more oxygen and helps rid your body of carbon dioxide and toxins.
• Drop your shoulders. When we get stressed, we tend to hunch our shoulders upward. After a while, we get knots in the muscles between our neck and shoulders. Pull your shoulders down; reach for the floor. Did your shoulders go down significantly? That’s a good sign that you’re a shoulder huncher. Do your reach for the floor exercise periodically, especially in conjunction with deep breathing. This will not only help stretch out the muscles (especially the trapezius), but helps you to be aware of when you’re hunching your shoulders.