Mind-Body Fibromyalgia Treatments

Biofeedback, Hypnotherapy and Cognitive Behavioral Therapy

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Fibromyalgia treatment is difficult, and drug therapy is rarely 100% effective at controlling symptoms. That leads a lot of us to consider complementary/alternative medicine (CAM), but it can be hard to separate hype from fact when looking in to different methods.

Fortunately, researchers are beginning to identify what actually works for fibromyalgia. The following information is a summary of scientific research on some of the more promising mind-body CAM techniques as fibromyalgia treatments, and it comes from the highly reputable website UpToDate, which is trusted and regularly used by doctors and other healthcare providers.

If your doctor isn't experienced with these kinds of treatments for fibromyalgia, this is the kind of fact-based information that can help both of you determine the best CAM treatments to try.

From UpToDate:

"EMG biofeedback, hypnotherapy, and cognitive behavioral therapy - These methods of therapy have shown some usefulness in selected patients with fibromyalgia.

  • "EMG biofeedback intervention resulted in significant improvement in pain, morning stiffness and tender points in one study and in pain, depression and function in another uncontrolled and unblinded trial in 12 patients that used biofeedback to manipulate heart rate variability, a marker of autonomic dysfunction.
  • "Hypnotherapy was found to be better than physical therapy in 40 patients with refractory fibromyalgia. The hypnotherapy group demonstrated better outcome in parameters such as pain, fatigue, sleep and global assessment, although not in tender point examination.
  • "Both mindfulness meditation-based relaxation response program and cognitive behavioral therapy (CBT) have been helpful in studies of patients with fibromyalgia. Meditative stress reduction was beneficial for depression in an eight-week study that randomly assigned 91 women with fibromyalgia and depressive symptoms to meditation or a waiting list. CBT resulted in improvement in ten different target variables in 22 patients with fibromyalgia studied for a mean of 30 months after completion of the therapy. A small, randomized trial (n=47) found CBT for insomnia in patients with fibromyalgia significantly improved sleep quality compared to sleep hygiene instructions, or usual care."

What is EMG Biofeedback?

Biofeedback uses instruments to measure things like muscle tension, brain activity, heart rate and skin temperature. The information it provides can help you be more aware of how your body reacts to physical or psychological stress. Once you're aware of your reactions, you can work on changing them.

For example, if you clench your jaw every time you feel a twinge of pain, you could develop pain in the jaw and the tissues that connect to it.

Biofeedback is frequently used to treat stress-related conditions, including high blood pressure, eating disorders, some anxiety disorders and certain types of headaches. It's also used to help people learn how to relax more deeply. It's most often performed by physicians, physiologists, kinesiologists (movement specialist) and psychologists, but it may also be done by other health-care workers.

EMG stands for electromyograph, which is the machine that records information on muscle tension from sensors placed on your body.

While there are no known side effects of biofeedback, it's not advised for all conditions. In the studies cited by the above UpToDate article, one found that clinically depressed fibromyalgia patients responded poorly, while the other found a reduction in depression symptoms. Be sure the biofeedback practitioner knows about all of your conditions before you begin treatment.

What Is Hypnotherapy?

You're probably somewhat familiar with the concept of hypnotherapy. It's frequently used to help people with issues, such as quitting smoking and losing weight. A hypnotherapist puts you in an extremely relaxed state and then uses the power of suggestion to trigger changes in your brain that are believed to improve both physical and mental health.

The study mentioned above examined how hypnotherapy helped people with "refractory fibromyalgia." Refractory means that they've had very little luck with other treatments.

Hypnotherapy has been used to treat issues such as phobias, anxiety, high blood pressure, headaches and irritable bowel syndrome.

What Is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a type of short-term psychotherapy that is typically used to change the way you think of and behave toward something, such as sleep.

For example, years of insomnia can create negative mental images of what it means to go to bed (i.e., frustration, anxiety rising pain levels), and that may cause you to stay up late and become stressed about even attempting to sleep. In CBT, a therapist would try to help you change your thoughts and attitudes about going to bed and also change your behavior by helping you establish and follow a better nighttime routine.

CBT is used to treat conditions, such as panic disorder, eating disorders, irritable bowel syndrome, certain anxiety disorders and addiction.

The recommendation of CBT as a fibromyalgia treatment does not imply that fibromyalgia is a psychological disorder. What it means is that the ways we feel and behave can have an impact on our health. If you can sleep better, eat healthier, motivate yourself to exercise and have a better attitude about your illness, your symptoms are likely to improve.

Want to learn more? See UpToDate's topic, "Treatment of Fibromyalgia in Adults" for additional in-depth, current and unbiased medical information on fibromyalgia, including expert physician recommendations.

Source:

Goldenberg, Don L. "Treatment of Fibromyalgia in Adults". UpToDate. Accessed: January 2009.

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