Alternative Medicine Meets Fibromyalgia
It was a tough group of fibromyalgia patients that a team of alternative medicine and mind/body practitioners took on. They had not responded well to other therapies and had so many co-morbid disorders (over 700 diagnoses in total) that the authors stated they would “not be presented due to their complexity and scope.” The average visual analogue pain scale scores averaged out at about 7.0 which meant they were in severe pain.
Fibromyalgia with severe forms of progression in a multidisciplinary therapy setting with emphasis on hyperthermia therapy – a prospective controlled study. Romeyke T, Scheuer HC, Stummer H. Clin Interv Aging. 2014 Dec 19;10:69-79. doi: 10.2147/CIA.S74949. eCollection 2015.
They had responded so poorly to treatments that they were picked to participate in an extended in-hospital stay where the Austrians threw the alternative medicine book at them. Over their approximately two week stay everyone received phytotherapy/mind-body therapies, hydrotherapy, lifestyle regulative therapy and movement therapies. In addition some people received detoxification, neural therapies, homeopathy and diet advice. One group received heat treatments (plus the other other therapies) while the other didn’t.
Gate Control Theory of Pain
The psychotherapy and CBT focused on providing methods of coping with pain and deflecting attention, problem solving and learning how to manage their illness better. The kind of CBT used was based on the gate-control theory of pain.
This theory posits that increasing the activity of nerves that do not relay pain signals will decrease the activity of nerves that carry pain signals. It helps explain why when you’re in pain and you consciously distract yourself your pain usually lessens. It also helps explain why people in chronic pain often experience significant placebo effects.
One of the goals of gate-control based therapies is to increase other kinds of sensory input than pain. We’ll be digging deeper into this theory later.
In addition to the other therapies half the patients were given heat therapy or hyperthermia. Many different types of heat therapy, from hot water baths to whirlpools to mud baths to steam baths exist, but in what appears to be tech speak for an infrared sauna, the study stated that the participants were given”whole-body hyperthermia with IR radiation” while they were “lying in an insulated cubicle”
For a person with fibromyalgia and/or chronic fatigue syndrome perspective both positive and negative things can happen when you heat up your body. For a start your heat rate increases to levels experienced during moderate exercise – which could be problematic for people with ME/CFS in particular. Decreased “peripheral resistance” (blood flowing more easily through the blood vessels) and increased circulation on the other hand, could be helpful. Oxygen consumption and levels of the stress hormone norepinephrine increase.
The levels of pain reducing beta-endorphins plus muscle relaxation and increased elasticity of the tendons probably contribute to the relaxed feelings many people get in saunas. Dr. Rowe’s findings of reduced tendon elasticity in adolescents with ME/CFS suggests saunas might be helpful in relieving the movement problems in ME/CFS if other aspects of the sauna are tolerated.
Hyperthermia also may be able to inhibit bacterial and viral activity. Dr. Rea in Dallas has also successfully used sauna therapy for years to detoxify people with chemical sensitivities.
Even the Mayo Clinic has some good things to say about sauna therapy
“Several studies have looked at using infrared saunas in the treatment of chronic health problems, such as high blood pressure, congestive heart failure and rheumatoid arthritis, and found some evidence of benefit. However, larger and more-rigorous studies are needed to confirm these results.”
During their stay the hyperthermia group received, on average 5 hyperthermia treatments between 37.5 and 38.5 (100 degrees Fahrenheit) degrees in what appeared to be an infrared sauna.
The visual analogue scale (VAS) indicated that the mean level of pain on admission was 6.8 for the control group and a whopping 8.2 (very severe pain) for the group receiving hyperthermia.
The results suggest that this kind of intense multi-dimensional approach to pain reduction can help. The average pain levels of those not receiving the hyperthermia treatment dropped by thirty percent (VAS = 6.8-4.8) These FM patients were definitely not out of pain – they still averaged 4.8 on the VAS, but they went from feeling somewhere between dreadful and horrible to somewhere between feeling uncomfortable and dreadful (at least according to his visual analogue scale – which is not necessarily the one they used.).
The patients receiving heat treatments plus the other treatments started off worse (VAS=8.2-6.8) and improved more (VAS = 4.0 -4.8) than the patients not receiving heat treatments. Instead of feeling “horrible” they were now simply “uncomfortable”. Their “functional capacity” was significantly increased as well.
Results Suggest Heat Treatment More Effective Than Physical Therapy
An analysis indicated that the control group ended up receiving much more physical and movement therapy than the heat treatment group. That suggested that heat treatment was more effective than physical therapy in reducing pain and improving functionality. (The amounts of phytotherapy, psychotherapy/mind/body, detoxification, neural therapies, homeopathy and diet advice received from the two groups was the same. )
The decrease in pain the FM patients received from the hyperthermia treatments and the in-hospital stay was both gratifying and sobering. It indicated that providing multiple alternative and mind/body treatments during an in hospital stay can significantly reduce pain. Whether such intense and expensive types of treatment are feasible or cost-effective is another question.
The increased functionality and greater pain reductions experienced by the patients receiving infrared heat treatments, on the other hand, was promising. If they’re accessible, heat treatments are very simple to use.
Infrared vs Traditional Heat Saunas
This study used a type of sauna – infrared saunas – that have become increasingly popular over the past ten years. Traditional saunas heat the air to sometimes astonishing temperatures (up to 180 degrees) which then heats the body from the outside in. They’ve been successfully used for detoxification and other purposes for decades.
Because the traditional sauna method of heating (convection heating) doesn’t penetrate the body as deeply as the radiant heat of infrared saunas, proponents of infrared saunas assert they are better at detoxing. Because infrared saunas operate at lower temperatures people are often are able to stay in them longer and sweat more.
Both saunas are effective at detoxification and in raising the body temperature but infrared saunas appear to be more easily tolerated.
My Experience With Sauna Therapy
I underwent sauna therapy at Dr. Rea’s practice about 30 years ago. He used exercise – to get the toxins out of the muscles and into the bloodstream, supplements and fiber – to soak up and detoxify the toxins, and sauna – to remove the toxins via sweating.
Watching multiple chemically sensitive (MCS) patients whale away at the exercise cycles made it clear that ME/CFS and MCS do not share some core problems. I quickly dropped the exercise session but I engaged in one to two sauna sessions a day for six weeks. Being in a hot traditional sauna for me is equivalent to engaging in exercise and it was a painful process. I left the program thinking it was a failure but two days later driving home I experienced feelings of wellness I hadn’t experienced for years.
I intermittently used traditional saunas since then and often experience increased clarity of thought, increased energy, etc. from them which sandwiched in between strong symptoms flares. I could never bring myself to use them regularly again.
This study found that intensive in-hospital stays using alternative and mind/body techniques can lead to significant reductions in pain in severely ill fibromyalgia patients.
In addition infrared saunas, when used in combination with other methods, may be able to provide moderate to significant pain relief. Given their much lower temperatures infrared saunas are probably preferred for FM and ME/CFS patients.