Chronic Pain and Fibromyalgia

The diffuse muscle pain associated with fibromyalgia can be debilitating. Unless you’ve experienced the achy all over pain that accompanies fibromyalgia you can’t imagine the amount of discomfort, stress, and fatigue it creates. For those people who don’t know what fibromyalgia is like, I ask them to imagine waking up everyday with the flu from hell.

The pain can become worse when the individual gets under more stress (depleting serotonin), the weather changes, and after being on certain prescription medications for extended periods of time (Ambien).

Pain

Pain may arise from wear-and-tear arthritis (osteoarthritis), scar tissue, lactic acid (trigger points), allergic reactions, leaky gut, intestinal dysbiosis (yeast overgrowth), nightshade sensitivity, autoimmune disorders (rheumatoid arthritis), low serotonin levels or poor detoxification processes. Finding and successfully treating the source of chronic pain can be difficult.

Pain is initiated from inflammatory chemicals that are released in response to injury. Pain acts as an alarm to warn us of potential danger. If you’ve ever placed your hand on a hot stove, you know pain acts as a potent deterrent to not make this mistake twice. Wherever there is pain, there is inflammation. Inflammation is a normal and important, bodily reaction. Inflammation allows the body to attack unwanted invading microorganisms (viruses, bacteria, etc.), remove damaged cells (from injury), eliminate toxins, and is part of the body’s repair process.

How the inflammatory system works

Trauma, infection, ischemia (reduced blood flow), toxins, poisons, and normal wear and tear cause damage and destruction to cells. This damage then triggers an orderly inflammatory response by the body’s self-regulating mechanisms. When cells become damaged, they release special enzymes. These enzymes digest the parts of the cell that have been damaged. If the damage is minor, the cell can repair itself. If the damage is severe, the entire cell is digested (autolysis) and a new cell is made. If a lot of cells (tissue) are damaged, either by trauma (sprained ankle, back joint, etc.) or autolysis (cell death from toxic exposure, radiation, etc.), certain chemicals are released into the surrounding tissues, producing inflammation and more pain.

Inflammatory chemicals

The first group of chemicals, histamine, leukotriens, and pro-inflammatory hormones (prostaglandins), cause the blood vessels to dilate or expand. The dilation of the blood vessels causes the area to become hot, red and swollen. The dilated vessels (capillaries) allow needed nutrients and white blood cells to get to the damaged (swollen) area.

The white blood cells are charged with digesting and removing damaged cells (phagocytosis). These white blood cells gobble up everything in sight. Foreign invaders or pathogens (viruses, allergens, free radicals, etc) release their own chemicals, many of which are toxic. The healthy tissue surrounding the damaged area releases anti-inflammatory prostaglandins (PG1 and PG3) to combat the inflammatory prostaglandins (PG2). Certain chemicals (proteolytic enzymes) are responsible for telling the white blood cells that their job is done. These chemicals sound the alarm for the white blood cells to stop attacking and digesting cells and tissues.

Proteolytic enzymes are manufactured to squelch the white blood cells from continuing to eat up cellular debris. As the damaged cells and tissues are removed, less of the pro-inflammatory chemicals and more of the anti-inflammatory chemicals are released
. Once the inflammation process is finished, the body begins to repair itself.

The balance between inflammation, destruction, and repair is an ongoing process. Normally, this process is kept in check. When the process becomes unbalanced, chronic inflammation takes over.

Inflammation is largely regulated by the prostaglandin hormones mentioned above.

Prostaglandins

Prostaglandins are a group of regulatory hormones produced in the body from fatty acids. There are several different groups of prostaglandins, but inflammation is largely controlled by Prostaglandin 1 (PG-1), Prostaglandin 2 (PG-2), and Prostaglandin 3 (PG-3).

PG-1, PG-2, and PG-3 are produced from essential fatty acids.

Essential fatty acids are essential for our existence. They can’t be manufactured by the body but must be obtained from the foods we eat. Essential fatty acids are made-up of polyunsaturated fatty acids (PUFAs).

PUFAs are divided into two families of essential fatty acids (EFA).

PUFAs are further broken down into Omega 3 (fish oils) and Omega 6 (vegetable oils).

Anti-inflammatory hormones

PG-1 and PG-3 come mainly from Omega 3 oils (fish oils) and are anti-inflammatory hormones. They help reduce and eliminate inflammation and pain.

Arachidonic Acid (AA) PG-2 Causes Pain and Inflammation

AA is an essential fatty acid (EFA) in the Omega 6 family. AA is found in corn and corn oil products. Corn products are used as the prominent foodstuff in westernized livestock. Red meat, dairy, and pork products have a high AA content.

The pro-inflammatory series PG-2 are made from arachidonic acid. Arachidonic acid is derived from the consumption of land animal foods (meats, cheese, eggs, etc.). Arachidonic acid stimulates the production of inflammatory chemicals including leukotriens (notorious in causing allergic reactions), thromboxanes, and prostacylins. Several research articles have demonstrated that the more animal fats a human eats, the more arachidonic acid they have in their blood and cell membranes and the more likely to have inflammation.

Conversely, a diet high in fish or supplemented with fish oil (EPA) helps reduce inflammation.

A. Omega 3 Linolenic Acid

Omega 3 oils include are found in flax seed, soybean, walnut, and chestnut oils, as well as some dark green leafy vegetables.  Eicosapentaenoic Acid (EPA) and DHA (docosahexanoic acid) are Omega 3 derivatives and are only found in cold water fish. These fish include salmon, tuna, and mackerel

The average AA (PG-2 from vegetable oils and animal products) to EPA (PG-1 and PG-3 from fish oils) of Americans is approximately 11:1. For patients with inflammatory conditions and neurological disorders, the AA/EPA ratio is 20:1 or more.

This means that Americans are eating and storing 11-20 times the amount of inflammation causing hormones (from vegetable oils and land animals) in comparison to the inflammation reducing hormones (from fish oils).

An AA/EPA ratio of 1.5:1 is considered ideal. This is the ratio found in Japanese populations which by the way have the highest life expectancy and the lowest rate of cardiovascular disease.

Our inflammatory reactions and their chemicals are therefore largely determined by what foods (fatty acids) we eat. Since most Americans are carrying around at least 10-20 pounds of excess fat, it is no wonder that arthritis and other inflammatory diseases are out of control in our country.

The average adult weighs 150 pounds, 30% of this is fat. This means that on average a person is carrying around 45 pounds of inflammatory fatty acid hormones!

Fish Oil Reduces Pain and Inflammation

The supplementing your diet with fish oils along with reducing the intake of arachidonic acid foods (land animals) can yield significant results.

Some studies have shown that supplementing with fish oils results in a dramatic reduction in a person’s leukotriens (one of the chemicals implicated in asthma) by 65%. This correlates with a 75% decrease in their clinical symptoms.

Another fish oil study, involving rheumatoid arthritis sufferers (often treated with incredibly toxic and life threatening prescription drugs) who took 1.8 grams of EPA fish oil and reduced their saturated fats (land animal foods), showed significant improvement over and above a placebo.

Sleep deprivation and pain

One study showed that college students who were prevented from going into deep sleep (REM sleep) for a period of a week, developed the same symptoms associated with fibromyalgia (FMS) and chronic fatigue syndrome (CFS): diffuse pain, fatigue, depression, anxiety, irritability, stomach disturbances, and headaches.

A study conducted by the University of Connecticut School of Medicine compared the sleep patterns and associated symptoms of fifty women with FMS.

The study showed that a poor night’s sleep was followed by an increase in the subject’s symptoms including, increased pain.

Avoid instant coffee

Instant coffee contains substances which block the receptor sites for endorphins and may cause increased pain.

Nightshades

In one study 70% of those with arthritis reported relief from chronic pain over a period of seven years after eliminating all white potatoes, tomatoes, peppers,(except black), eggplant, and tobacco.

Supplements That Help Reduce Pain

S-adenosyl-l-methionine (SAMe) comes from the amino acid methionine and acts as a natural anti-inflammatory and blocks pain without the side effects associated with NSAIDs.

SAMe helps boost serotonin and epinephrine levels. It also helps increase the production of endorphins. Endorphins are the bodies natural pain blocking chemicals and are more powerful than morphine.

One double-blind study showed SAMe was superior to ibuprofen in the treatment of osteo-arthritis pain.

Several studies involving SAMe and fibromyalgia patients yielded substantial improvement in over all pain levels (as well as depression).

Dosage is up to 1,200 mg. taken on an empty stomach 30 minutes before breakfast each day.

Malic Acid is found in a variety of foods. It is a vital nutrient needed for the production of cellular energy (Krebs cycle). Malic acid helps boost cellular energy and reduce achy muscles. It removes unwanted waste material from muscle cells including lactic acid, a byproduct of oxygen deficiency.

Lactic acid has been implicated as one reason for achy muscles. Lactic acid may accumulate in muscles after periods of anaerobic and aerobic exercise. It may also be involved in the trigger point pains associated with fibromyalgia.

“Malic acid gave subjective improvement within 48 hours in one study.”

Sherry Rodgers M.D., Pain Free in Six Weeks.

Studies involving FMS patients who were taking magnesium and malic acid together showed dramatic reduction in pain levels that returned with in 24 hours of discontinuing the supplements.