Fibromyalgia: treatment with Tuina

We have seen that the Tui-Na is an integral part of Traditional Chinese Medicine and has been the first that has accumulated rich clinical experience, providing many years of valuable experience.

Fibromyalgia is a common condition that causes pain and fatigue in the muscles, joints, ligaments and tendons.

According to Traditional Chinese Medicine, pain points that are described in most cases of fibromyalgia are acupuncture points that are related to blockages in the meridians, and linked to diseases of the organs, principally in liver, Kidney, Spleen and Heart.

What is fibromyalgia?

Fibromyalgia is a common clinical syndrome of widespread musculoskeletal pain, stiffness and chronic pain, characterized by tenderness at specific points of anatomy.

The causes of fibromyalgia are not known yet. It has been reported to begin after an infection, an accident, a separation or problems with children (emotionally disturbed). It can also appear after another illness, limiting the quality of life of patients (arthritis, lupus erythematosus, rheumatoid arthritis, hemiplegia…).

Any of them could be the triggering agent of the disease in those who already have a defect in their responsiveness to certain stimuli. Although it seems that the emotional component is a very common symptom, and experts generally agree with combined treatment with antidepressants.

There are no blood tests or imaging techniques that are specific to diagnose fibromyalgia. We are researching to find evidence to confirm the diagnosis but for now, none is satisfactory in the short term.

The American Academy of Rheumatology has determined that these should be the requirements that must be met to establish the diagnosis of fibromyalgia. Musculoskeletal pain should be extensive and widespread throughout the body and for a period of at least 3 months. An examination of the sensitive points of maximum pain, we will give 11 of the 18 are positive. These points are in the neck, shoulders, chest, hip, knee and elbow.

Symptoms

Fibromyalgia symptoms occur at different frequencies according to the patients, being affected to a greater or lesser degree. These symptoms also tend to vary in relation to the time of day, activity level, lack of sleep or stress.

"The back hurts me, head, legs, hands …, I cannot sleep well, I'm so tired I'm dragging all day, I’m really tired and with pain, I took quantities of pills to relieve it, and I do not know what to do…"

That's the main complaints of my patients. The complaint is widespread pain, which has been previously diagnosed as fibromyalgia. Incapacitating pain and medication will not decrease enough, so go for consultation of traditional Chinese medicine to try to reduce or even eliminate the pain.

In my clinical experience, the main symptoms in fibromyalgia are pain and chronic fatigue, usually accompanied by an emotional component, due to stress, lack of sleep, etc.

Pain: is a type of diffuse pain, which affects different parts of the body, mainly located in the cervical spine, shoulders, arms, buttocks and the knees. Usually involves the mornings and muscle groups that have been used repeatedly.

Fatigue: The energy loss is the biggest complaint of most patients with fibromyalgia and limitations may cause more pain.

Sleep Disorders: A large percentage of fibromyalgia patients have sleep problems, worsening symptoms on not sleeping well or enough.

Headache: About half of patients suffer from chronic headaches, migraines that can also occur with nausea, vomiting and sore eyes.

Paresthesias: Apart from the pain, often manifested a numbness or tingling in the extremities.

Dry mouth and eyes: Approximately one third of patients can have these symptoms.

Chest pain: Sometimes, some have muscle pain in the insertion of the ribs to the sternum, which is known in Traditional Chinese Medicine, as Chest Bi syndrome.

Depression: It is difficult to define whether there is a causal link, since most patients with fibromyalgia suffer from depressive symptoms.

Dysmenorrhea: It is common for this dysmenorrhea and / or Premenstrual Syndrome.

The meridians and diagnosis

To understand, each case must be considered individually, each separately, – the doctor makes a diagnosis, according to the fundamental theories of Traditional Chinese Medicine, the Theory of Yin-Yang, the five elements, Zang-Fu ( organs), Jing Luo (meridians), Qi-Xue (energy and blood), Jing-Ye (body fluids), further research on the etiology and finally obtain the differentiation of syndromes.

The Jing Luo (meridians), are distributed throughout the body, related Zang-Fu internally and externally on various tissues and organs, thus forming an integral whole. The function of the meridians, carry Qi – Xue, warm and nourish the tissues, and connect the entire body is maintained so that completes the structure and coordinate the various Zang-Fu organs, limbs, bones, etc., making that the human body is an organic unity.

These functions play an important role in the clinical treatment of fibromyalgia. Locating trigger points allows us to observe, what meridians or energy channels are affected. Localized pain at points indicates blockage, stagnation, obstruction, or overloading of the meridians.

Interestingly, the 11 positive tender points in patients with fibromyalgia points coincide with acupuncture meridians, which had already been stated in the section "pains in Su Wen Huang Di Nei Jing", "where there is a blockage, no pain."

The five elements

If we stick to the Theory of the Five Elements, the five movements "where each of the elements are closely interrelated and pathology, we can pass from one element to another. According to clinical experiences in cases of fibromyalgia, the condition usually starts in the Wood element, which includes the Liver and Gallbladder, and collects the affections of the tendon-muscle system, and excitement that is directly related to the irritability and aggressiveness. Continue with the Fire element, which includes the Heart and Small Intestine, and reflects the conditions of blood vessels, regulating the joy of life, is the set of named Shen (the psyche). It also tends to affect the Earth element, focusing on Spleen and Stomach, or the Water element, which corresponds to the kidneys and bladder. The metal element, which includes lung and large intestine, is less affected.

The diagnosis is therefore, according to Traditional Chinese Medicine, a multidiagnosis, which often manifest in the following syndromes:

• Liver lock that becomes a fire.
• Block Qi, Tan-heat disturbs the Heart.
• Heart failure and spleen simultaneously.
• Xue Yin deficiency and Liver.
• Yin fire for Liver failure and / or kidney.
• Disorders between the Fire (Heart) and Water (Kidney).

Tui-na therapy

After a thorough diagnosis, we know the organs and meridians that are most affected.

The fibromyalgia can counteract with acupuncture, traditional Chinese herbal medicine and Tui-Na (Chinese therapeutic massage).

Tui-Na

According to the worst affected areas apply the Tui-Na treatment, and its basic functions:

• Unlocking the meridians
• Activation of the circulation of Qi-Xue
• Regulating the functions of Zang-Fu
• Lubrication of the joints
• Increased human body's defense system

In clinical practice, the 11 main techniques of Tui-Na for the treatment of fibromyalgia are as follows:

• Tui Fa: vertical and directional pressure
• Na Fa: assemble and clamp
• An F: Press
• Mo Fa: gentle kneading, rubbing in circles
• Chan Yi Zhi Fa: monodigital oscillating pressure
• Gun Fa: rolling massage
• Rou Fa: deep kneading and rotating
• Ca Fa: friction (80-150 / minute)
• Cuo F: friction mixer tips
• Fen Jin Fa: deep transverse massage
• Pai Fa: percussion.

Source: European Foundation of TCM – TCM College

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