Fibromyalgia, Evidence Based Medicine and ‘Complementary / Alternative’ Practices

“Question everything”, Maria Mitchell

Frustrated that there is not much hope for relief from the usual medical system and its approach to fibromyalgia, many turn for help to practitioners who provide either complementary or alternative medicine (C/AM). The differences between the latter two is an artifical separation since they both entail using concoctions, therapies, herbs, or homeopathic remedies that are one and the same. The more interesting issue is how  they differ from the traditional scientific ‘western’ medical approach, or what has been known as ‘allopathic’ medicine, or now commonly referred to as ‘evidence based medicine’ (EBM) of health care. However, within this discussion I do not refer to EBM as within the domain of CAM as many ‘alternate’ practitioners are prone to do.

What makes something considered to be complementary or alternative as opposed to mainstream, or scientifically based medicine?  Sometimes this distinction becomes blurred and confused with one another, for example, taking vitamins or supplements. Are they the domain of EBM or AM ?  Is it because there are scientific experiments that provide evidence that specific vitamins are essential for healthy living, as in the recent data on Vitamin D? As usual, I have more questions than answers. Sometimes the issues are not clear cut with many shades of gray.

Simply put when an approach is complementary it is in addition to the usual western/scientific approach to illness or disease, whereas alternative is when a therapy is in place of western/ allopathic medicine. But the problems are more complex when it comes to defining what differentiates EBM from that which many define as ‘natural’, meaning an alternative (AM) to that which is prescribed by a physician (or in some places where it is legal, for a pharmacist to prescribe). For many in the alternative realm the traditional health care system is thought to be somewhat toxic and they believe that medications can often cause more damage than help because they are primarily chemically based. Generally it is a denigration of even the advances of EBM. It is often associated with a view of returning to the days before we became over medicalized. By contrast, for most of those in the EBM field, AM is said to be ‘pseudo-science’, ‘junk science’, or ‘voodoo science’ (for a description of these terms see Robert Park’s book: Voodoo Science The Road from Foolishness to Fraud).  Some attempt to straddle the fence and incorporate both in their practices, that is, a marriage between the fields of traditional medicine and naturopathy or homeopathy, but they are in the minority.

For many people with fibromyalgia the recurrent visits to physicians can result in less than satisfactory results as the search for relief from the debilitating symptoms can be exhausting and not particularly helpful. It is not surprising therefore that people will turn to alternative solutions. I was among them.

Sometimes I can barely recall all of the ‘therapies’ and herbal and homeopathic solutions I have partaken of over many years. Let me list a few: flower essences, acupuncture,  aromatherapy, homeopathic solutions, magnetic therapy, and Chinese herbs. I have gone to acupuncturists, homeopaths and naturopaths. I have taken QiGong courses and Jin Shin classes, both of which have promised more than they can deliver with regard to healing. I have bought round magnet discs for my wrists as well as a bracelet of magnets. For the most part these were expensive, in particular the Chinese herbs (which I had to boil for ‘tea’) and the homeopathic concoctions. All of these were sold to me in some form or other for a relatively high cost, by differing  practitioners. In desperation I wanted to try anything that would have decreased my pain and fatigue. In the end, after many years of searching, much expense, none of these complementary systems worked to decrease my pain or fatigue. Nonetheless, I have known many who have found relief from one or many of the above systems of treatment. There are the critics and skeptics who suggest that it is the placebo effect, that is, if you think something will help, it can have such a powerful effect (the mind/body connection) that positive results will occur. (See Ben Goldacre’s blog The Bad Homeopath wherein he cites that huge meta-analyses were conducted with vast numbers of homeopathic trials and it was found that homoepathic treatments were ineffective except for the placebo effect). I wish it had been so for me, as I was willing to try most systems to achieve relief, and hoped each time that the sought-for ‘cure’ would be found. Often I stayed with the regime long after I recognized that it was not helpful. Most of the women whose stories are found in my book had been involved with one or several of these alternative practices; some found short term success, others did not long term.

But, to get back to one of my first questions: is something like taking a vitamin part of the scientific/allopathic system of health care or is this an alternative/complementary approach? Even more tantalizing, why doesn’t acupuncture work well with fibromyalgia sufferers when it is an old and somewhat respected tradition? Isn’t it now considered somewhat mainstream among many physiotherapists (physical therapists)? Don’t many of our current prescribed and over the counter medications have a botanical basis? Are all herbs potentially harmful if they have not been ‘scientifically’ tested, provided evidence of their efficacy and approved? What is a folk remedy? For example, isn’t boiling peppermint leaves good for digestive upsets? Is it as effective and less harmful than antacids?

The questions are numerous but we cannot ignore that there has been a great surge of interest of late in the return to an era when there was less intervention of the health care industry in our lives. However, the alternative/complementary approach is guilty of swaying us toward what may very well be a romantic notion of natural ways of healing. What do we do in the meantime  as we live life in a daily attempt to alleviate our distress? The only hope there is for me is to try to live life as fully, quietly and gently as possible in order to calm an over aroused nervous system and not place too much faith in a quick fix from those who promise a ‘cure’.

5 thoughts on “Fibromyalgia, Evidence Based Medicine and ‘Complementary / Alternative’ Practices

  1. Kristy Stanton

    thanks again, Barbara. Just where is that magic pill when we need it? ha! When one researches re: fibromyalgia one does find lots of “garbage.” Thank you for sharing YOUR insights and for providing helpful guidance.

  2. Shirley Coy

    I have been suffering with fibromyalgia for many years, I’ve come to believe I have to just live with the pain. I came accross this website that makes alot of sense. I hope something helps me!!

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