What Is Fibromyalgia?
Fibromyalgia (FM) is a chronic musculoskeletal and neurological disorder characterized by widespread pain and tenderness throughout the body. It has been shown to have a genetic predisposition in families. In accordance with the American College of Rheumatology guidelines, the diagnosis of FM is based on a history of chronic widespread pain (on both sides of the body plus above and below the waist) and the finding of at least eleven out of eighteen tender points by a physician (Arthr. Rheumatol., 1990). The diagnosis also includes the following symptoms: fatigue, insomnia, memory and concentration difficulties, sleep disturbance, heart/blood pressure problems, morning stiffness, and gastrointestinal (GI) complaints with potential weight gain.
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME), a condition where postexertional fatigue is a predominant symptom, is a related and overlapping condition with fibromyalgia. the National ME/FM Action Network's website at: http://www.mefmaction.net. Fibromyalgia is not a rare condition; it is, in fact, one of the most common rheumatic illnesses (Journal of Musculoskeletal Pain, 2004). A major concern in the field of women's health, FM is prevalent among 6 percent of women, according to the 2003 Canadian Community Health Survey (CCHS). CFS/ME is also prevalent among 3 percent of women in the 2003 CCHS.
Despite volumes of international research, the cause of FM remains unknown. However, we do know that it is a recognized disease. Numerous studies have shown physiological disturbances among FM patients, including hormonal and neurotransmitter abnormalities. Functional MRIs of FM patients' brains show that they react differently than healthy peoples' brains to the same painful stimuli. FM patients are more sensitive to pain after the illness's onset. In fact, FM patients are more sensitive in general-this can include reactions to previously tolerated material, odors, and even food.
To date, research has not revealed a fully effective treatment protocol for FM patients, but there is evidence that low-dose antidepressant medication and carefully monitored exercise programs are of benefit. Recently, investigators have suggested that a multidisciplinary, holistic treatment approach-one that emphasizes education and support- may be the most appropriate. Based on clinical observations and published literature, we believe that proper dietary choices can be a helpful component in FM treatment efforts. How can dietary changes help? Almost half of all FM patients attempt dietary changes, according to research. Many report this as a helpful approach. Even more encouraging, over 70 percent of CFS/ME patients who attempt dietary change report it as the most helpful complementary or alternative intervention. These dietary changes are, however, commonly attempted without guidance and support. Patients are often unaware of alternative choices and meal plans, which usually results in poor compliance beyond the short term.
A number of research papers have shown that vegetarian and vegan diets, at least over the short term, can be beneficial in reducing FM symptoms. In a study published in the Scandinavian Journal of Rheumatology (Kaartinen et al., 2000), FM patients on a vegan diet for three months had a 30 percent reduction in tender point numbers and exhibited almost no need for painkillers. Increased intake of fruit and vegetable antioxidant and anti-inflammatory phytonutrients (natural chemicals that give plants their taste, color, and texture) is thought to play a part in the benefit of such diets. This does not mean that FM patients should become vegetarian or vegan; however, it does suggest that reducing proinflammatory animal fat, particularly red meat, and increasing fruits and vegetables may indeed be beneficial.
There is much discussion on the Internet concerning a possible link to nightshade family vegetables and autoimmune diseases (e.g., lupus, rheumatoid arthritis, ankylosing spondylitis). Nightshade vegetables include potatoes, eggplants, tomatoes, and bell/hot peppers, and it has been speculated that these foods might weaken autoimmunity. In recent years this theory has been extended into the realm of fibromyalgia. It is very important to note that there is absolutely no credible research to back up this theory in autoimmunity, let alone fibromyalgia. That said, as clinicians we have observed select patients whose conditions do appear to be aggravated by the aforementioned nightshade vegetables. As with wheat, dairy, and other food groups, the only way to truly identify a nightshade sensitivity is through elimination and challenge. If you find an exacerbation of symptoms with any members of the nightshade family, then by all means eliminate them. However, to give blanket advice to all fibromyalgia patients calling for the elimination of nightshade vegetables is inappropriate. Experimental studies, for example, show that eggplant has anti-inflammatory properties, and tomatoes, eggplants, and bell peppers are all rich in antioxidants- desperately needed antioxidants. If you do have a sensitivity to nightshades then substitute purple cauliflower, cabbage, carrots, and dark green vegetables like spinach, bok choy, and kale, and use sweet potatoes while avoiding regular spuds.
