Fibromyalgia- A “Widespread Pain” Disorder

Introduction

Fibromyalgia is a chronic pain syndrome and the most common rheumatic disorder affecting 3-10% of the general population worldwide. It is characterized by musculoskeletal pain, fatigue, stiffness, cognitive symptoms, etc. According to Ayurveda, this condition shows Angamard (body ache) as the main symptom and this disease shows congruence to various diseases like Amavaat (RA), Maansgat Vata (imbalance of Vata in muscles and fat tissues), and Rasagata Vata (imbalance of Vata in lymph, circulating nutrients or plasma). This disease is considered a subtype of Vataja vyadhi (disorder due to aggravation of Vata). In this disease, accumulation of Ama and aggravation of Vata are the main causes and should be treated. The prevalence of fibromyalgia disease is 10: 1 i.e 10 times more in women than in men. Different mental, physical, and social influences lead to fibromyalgia. In modern medicine, the medications that are given to fibromyalgia patients do not provide a complete cure and have side effects like blurred vision and dryness in the mouth, etc. On the other hand, management by different Ayurvedic procedures may prove beneficial to cure fibromyalgia completely without side effects.

Facts to know about Fibromyalgia:

• 90% of the patients suffering from fibromyalgia suffer from sleep disorders and excessive fatigue.
• Fibromyalgia patients experience pain in four quadrants of the body for more than 3 months.
• Fibromyalgia affects 3-10% of people worldwide.
• Fibromyalgia is more common in women than in men and cannot be ruled out by any test.
• Fibromyalgia is not a degenerative disorder and does not damage joints.

Stages of Fibromyalgia:

There are four main stages:

1. Regional fibromyalgia with classical symptoms
2. Generalized fibromyalgia with increasing widespread pain
3. Fibromyalgia with increased sleep disturbances, widespread pain, chemical sensitivity, and associated advanced conditions.
4. Fibromyalgia is accompanied by other diseases.

Causes of Fibromyalgia

Ayurvedic point of view:

• Mala Sanchaya (Accumulation of toxic waste material)
• Krimi Visha (Microbial infection that gives rise to various toxins)
• Agnimandya (Low digestive fire)
• Dosha Sammurchana (Unhealthy interaction between the three Doshas i.e., Vata, Pitta, and Kapha)
• Ati-Shoka, Ati-Chinta, Ati-Bhaya (Over grief, overthinking, over fear)
• Ati-Vyayam (Excessive exercise, jumping, running, etc.)
• Ratri Jagaran (Staying awake at night)
• Ati Sheet (Excessive cold usually increases pain in joints)
• Ati-Adhwa (Excessive walking)
• Vega Dharana (Controlling natural urges)
• Parpaatnat (Falling during animal riding)
• Sheet Ahara (Intake of cold food)
• Alap Aahar (Intake of less food)
• Ati Asra Sravan (Excessive bleeding)

Modern point of view:

• Sedentary lifestyle
• Post-traumatic stress disorder (PTSD): People with poor mental health due to traumatic experiences like car accidents, painful delivery, etc. are very vulnerable to fibromyalgia.
• Depression and anxiety
• Genes: Fibromyalgia may be hereditary
• Disturbed sleep:  Irregular sleep cycles are the leading cause of fibromyalgia.
• Viral infection and other illnesses 

Symptoms of Fibromyalgia

Ayurvedic point of view:

• Angamard (Body aches)
• Hridya Gouravata (Heaviness in the chest)
• Sandhi shool (Pain in joints)
• Bhrama (Giddiness)
• Daurbalya (Weakness)
• Gatra Stabdhata (Stiffness in the body)
• Sandhi Greha (Stiffness in joints)
• Murcha (Unexplained fainting)
• Anaha (Retention of stool and gases)
• Agnivaishmya (Irregular digestion)
• Sira Aakunchan (Constriction of vessels)
• Anidra (Loss of sleep)
• Chinta (Anxiety)

Modern point of view:

• Fatigue 
• Irregular sleep patterns (Insomnia)
• Belly pain
• IBS (Irritable Bowel Syndrome)
• Queasiness
• Pain in joints
• Nausea
• Skin disorders
• Anxiety 
• Numbness and tingling sensation in feet, hands, legs.
• Painful cramps during menstruation.
• Morning stiffness
• Fibro Fog (group of symptoms that impair the ability to pay attention, focus, and concentrate

In most cases of fibromyalgia, the constant dull ache lasts for approximately 3 months.

Ayurvedic line of treatment:

The principle for the treatment of Fibromyalgia is co-related with the treatment of Amavaata. The treatment is as follows:

• Langhanam (fasting therapy) is the first measure that is advised in this condition to remove Ama (undigested food), but Langhan should be stopped as soon as Nirama (toxins made from Ama) state is achieved.
• Swedana (sudation therapy)
• Katu (pungent), Tikat (bitter) Dravyas should be used. Usually, they are not recommended in Vata disorder as they increase Vata but due to their Deepan and Paachan properties, they are highly recommended to digest Ama.
• Virechan (purgation therapy)
• Basti (enema therapy)
• Abhayanga (massage therapy)
• Upanaha (use of poultice)
• Panchkarma (ayurvedic detoxification) 
• Various combinations of herbs

Herbs useful for Fibromyalgia

For Improving digestive problems

• Saunth (Zingiber officinalis)
• Marich (Piper nigrum)
• Pippali (Piper longum)
• Hing (Ferula narthex)
• Chavya (Piper chaba)
• Chitrak (Plumbago zeylanica)

For Psychological health

• Brahmi (Bacopa monneiri)
• Jatamansi (Nardostachys jatamansi)
• Ashwagandha (Withania somnifera)
• Sankhpushpi (Convolvulas pluricaulis)

For pain and Inflammation:

• Shallaki (Boswellia serrata)
• Guggulu (Commiphora mukul)
• Rasna (Pluchea lanceolata)
• Agnimanth (Premna mucronata)
• Bilva (Aegle marmelos)
• Haridra (Curcuma longa)

For Immunity

• Amalaki (Emblica officinalis)
• Haritaki (Terminalia chebula)
• Giloy or Guduchi (Tinospora cordifolia)
• Madhuyashti (Glycyrrhiza glabra)

Dos and Don’ts (Pathya and Apathya)

• Use of soup and juices that are prepared from bottle guard, guard, tomato, pumpkin, carrot, beetroot, spinach, ginger root.
• Include coconut water and coconut milk in your diet.
• Take warm milk prepared with spices like ginger, cardamom, clove, Cinnamomum, etc.
• Include Khichdi (recipe made by Moong Dal and bran rice) in your diet.
• Avoid sleeping during the day and staying awake at night.
• Use spices like black pepper, asafetida, ginger, turmeric, cumin, etc. in your diet.
• Avoid fried and spicy foods.
• Avoid sugar and excessive salt in your diet.
• Avoid vegetables like cauliflower, cabbage, broccoli, potatoes, and brinjal.
• Avoid stress, grief, tension, etc.
• Practice meditation and yoga daily.
• Exercise regularly.
• Avoid eating raw food.
• Avoid coffee, black tea, chocolate, cocoa, etc.

When to see a doctor

Finding the right doctor for fibromyalgia is very necessary as this disease has symptoms related to multiple organs. So, you may need a rheumatologist, neurologist, or just a pain management doctor. You must visit a doctor if you experience pain in any of the below areas:

• The axial region – back, neck, abdomen, and chest
• The left lower region – buttock, hips, and legs
• The left upper region – arms, jaw, and shoulders
• The right lower region – buttock, hips, and legs
• The right upper region – arms, jaw, or shoulders

Conclusion

Ayurveda considers Fibromyalgia an imbalance in the energy of the body and mind (i.e nervous system imbalance) and not a disease. Research has revealed that imbalance of Ama and Vata is a common cause of fibromyalgia disorder. Ayurveda gives a ray of hope to the patient with fibromyalgia. You can ease away the symptoms of fibromyalgia by balancing Vata and removing Ama. Proper Ayurvedic treatment and regular consumption of the best quality recommended herbs is a great way to tackle fibromyalgia. 

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