Fibromyalgia is a clinical syndrome commonly associated with chronic musculoskeletal pain. It is characterized by a combination of symptoms including chronic generalized pain, sleep disorders, fatigue and cognitive disturbances1.
The exact cause and pathophysiology of this condition is unknown. Genetics, external environment, hormonal changes and neural factors are being studied as triggering factors to the condition2. Certain studies show that it can be considered a central sensitivity syndrome. This refers to amplification or alteration of neuronal signals that leads to increased perception of pain (nociception)3.
It has been considered that psychological factors and chronic stress may also play a role in the development of fibromyalgia and further studies are required in this field4.
Conventional medicine fails to provide specific treatments to patients suffering from fibromyalgia, and only offers palliative therapy that benefits only a small group of individuals. Evidence based treatment guidelines for fibromyalgia recommend the following classes of drugs – tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors (SNRI), anti-epileptic drugs, cannabinoids and opioids complemented by physical exercise5.
These therapies have short-term effectiveness with considerable side effects. Statistics highlight that about 90% of people suffering due to Fibromyalgia turn towards complementary medicine for symptom management5.
Classical homeopathy can be an effective alternative in the treatment of this type of pathology where conventional therapy has a limited role to play.
We present a case of fibromyalgia treated with homeopathy.
In July 2019, a 48-year-old Portuguese woman, during a rheumatology consultation, complained of intense generalized pain throughout the body, with a burning sensation in some parts of the body and numbness of the fingers and toes, especially in the morning, upon waking up. After several laboratory and imaging tests, she was diagnosed with Fibromyalgia (ICD10: M 79)
Treatment with the following daily medications was started: Adalgur N (muscle relaxant), and Dol-U-Ron (Codeine, a narcotic and analgesic).
Initial consultation:02. March. 2020.
The symptoms registered were as follows. Generalized intense pain throughout the body, with burning sensation aggravated by cold and damp surroundings. The pain was greater along the spine, at the dorsal and lumbar regions and in the joints of the hands, elbows and knees that improved with movement. She also complained of numbness and reduced sensitivity of her fingers and toes, especially in the morning, when she woke up.
Mental and Emotional state: Emotionally, the patient was depressed and professionally frustrated, with symptoms of irritability and impatience. She reported that between 2015 and 2018 she was involved in a very demanding professional project, to which she was deeply dedicated as its leader, hoping to be rewarded by her company. After completing the project, the expected recognition was given to another colleague, which gave rise to a feeling of great frustration, sadness and irritability. Since then, she has felt emotionally unstable and widespread pain began to emerge. She sighs frequently. Comparatively better at the end of the day and by walking outdoors.
Physical generals: Thermally chilly.
Cannot tolerate cold and dampness.
Sleep – unrefreshing, wakes up tired.
Personal medical history: Herniation of discs, L4-L5, at 20 years of age with pain in the region ever since. Pain in the ears on exposure to cold wind, for a few years. Several fertility treatments between the age of 35 – 38 years, without success. The patient has had no infectious acutes for the past several years.
Family History: Mother (69 years) – bladder prolapse, recurrent urinary infections.
Father (72 years) – Asthma and musculoskeletal problems.
Level of Health: Based on the medical history and present pathology of the patient, her level of health was evaluated to be in Group-C, level 7-8
From this analysis, Aurum metallicum was the remedy that stood out.
The essence of the medicine, the depression, associated with professional frustration and business failure in ambitious individuals, verified that this was the remedy with greatest similarity to the patient.
Prescription: Aurum metallicum 200CH, one dose at bedtime and Aurum metallicum 1M in the morning.
|06 August 2020||After starting homeopathic medicine, patient felt a slight increase in complaints. The pains were slightly better in intensity, but the burning and numbness did not show any change.
Headaches began at the root of nose.
Upon further investigation, she reported that she felt better emotionally, and that the body pains were now concentrated in the lower back and in the joints of the hands and knees, with less intensity and without a burning sensation. Numbness and insensitivity had also reduced.
As observed in the 20th observation from the Levels of Health6
On 16. July. 2020, the patient discontinued allopathic medication.
|13 January 2021||Physically, the severity of pain in the lower back and hand joints had reduced, without a burning sensation. The numbness and insensitivity of hands on waking up improved considerably.
Now, the pain in lower back and joints was more intense in the morning, with initial movement. It worsened in cold and wet weather and improved with hot application.
Emotionally, the patient felt more stable, with no signs of depression.
She was more irritable than before.
|Rhus Toxicodendron 1M, one dose.|
|20 July 2021||Patient had herniation of discs, L4-L5, at 20 years of age with pain in the region ever since.
After the previous prescription, pain in the lower back and joints of the hands were practically non-existent, even when waking up. Her quality of sleep, energy levels were good. She felt emotionally well.
Prescription: Rhus toxicodendron 1M, one dose.
Fibromyalgia is an incurable condition according to modern medicine. Studies show that a 50% reduction in pain is experienced at most by 10 – 25% of patients under pharmacotherapy7. A poor response to conventional pain treatment is seen in most cases. Therefore, to manage these cases, treatments are provided according to the condition and needs of the patient8.
Classical homeopathy approaches with a holistic perspective of the diseased individuals9. The diseased individual is dealt with according to the cause and symptomatology exhibited, and a personalized therapy is tailored for each individual based on the development of the condition, one’s hereditary disposition and the unique disease picture.
The level of health in this case is 7-8. The absence of acutes in the past few years with chronic complaint of disc herniation indicates that the case belongs to group C. When under duress, the patient developed fibromyalgia, further descending in the levels of health.
In this case, the pathology developed after being denied the recognition and reward she had worked for. The development of pathology and disease picture in Aurum metallicum as described by Prof. Vithoulkas as due to broken ambitions and broken attachments10. This leads them to a state of despair with depression of spirits and an absolute lack of enjoyment in everything.
When such a profound factor was recognized as the cause and the remedy selected was based on the same, we see improvement in the condition of the patient not only physically but at the emotional level as well.
With a betterment in the emotional symptoms, the older physical ailment, pain due to disc herniation at the lumbar region, L4-L5, intensified with clear indications of Rhus Toxicodendron, which prescription in turn took away the pain and ameliorated the symptoms of the patient at the physical level.
In this case, though there is improvement in the overall condition of the individual, the case is said to be under remission and not cured. In its current state, any significant amount of stress has the potential to return the case to its previous state. According to the Levels of Health and laws of cure in homeopathy, this case can be considered cured only when there is a reappearance of acutes which indicates a shift in the level of health6.
Individualized classical homeopathic treatment provides a better alternative to conventional therapy in the treatment of fibromyalgia. Further studies are required to evaluate its usefulness.
- RM, B. Clinical manifestations and diagnosis of fibromyalgia. Rheum. Dis. Clin. North Am. 35, 215–232 (2009).
- Benlidayi, I. C. Role of inflammation in the pathogenesis and treatment of fibromyalgia. Rheumatol. Int. 39, 781–791 (2019).
- Siracusa, R., Paola, R. Di, Cuzzocrea, S. & Impellizzeri, D. Fibromyalgia: Pathogenesis, Mechanisms, Diagnosis and Treatment Options Update. Int. J. Mol. Sci. 22, (2021).
- EL, P. Fibromyalgia–management of a misunderstood disorder. J. Am. Acad. Nurse Pract. 19, 341–348 (2007).
- Chinn, S., Caldwell, W. & Gritsenko, K. OTHER PAIN (N VADIVELU AND A KAYE, SECTION EDITORS) Fibromyalgia Pathogenesis and Treatment Options Update. doi:10.1007/s11916-016-0556-x.
- Vithoulkas, G. Levels of Health. vol. 2 (2010).
- RA, M., S, S. & D, A. Pain measures and cut-offs – ‘no worse than mild pain’ as a simple, universal outcome. Anaesthesia 68, 400–412 (2013).
- P, S.-P., D, B., M, C., A, D. & F, A. Treatment strategy in fibromyalgia syndrome: where are we now? Semin. Arthritis Rheum. 37, 353–365 (2008).
- S, M., M, M., D, T. & G, V. Homeopathic Treatment of Vitiligo: A Report of Fourteen Cases. Am. J. Case Rep. 18, 1276–1283 (2017).
- Vithoulkas, G. Materia medica viva. 03, 260 (2009).