By: Dr. Angela Jones Fibromyalgia syndrome (FMS) is a common rheumatological condition characterised by chronic widespread pain and ten­derness at specifically defined points. Painful stimuli are often felt very intensely(hyperalgesia) and non-painful stimuli, such as brushing, can also be felt as pain (allodynia). People with FMS often have other problems, including fatigue, depression, anxiety, sleep dis­turbance, headache, migraine, variable bowel habits and diffuse abdominal pain (irritable bowel syndrome) and urinary frequency. It is also said to be found more frequently in patients diagnosed with rheumatoid arthritis and systemic lupus erythematosus (SLE). What causes FMS? The cause of FMS is not known. It is likely that different people diagnosed with FMS are actually suffering from the symptoms for different reasons and some of the suggestions include hyper-excitability of the central nervous system and alterations in the mechanisms for the perception of pain as well as inter­actions with the limbic system which governs sleep, and stress and immune regulating systems. How common is FMS? Estimates of how many people suffer from FMS vary. A US population study in 2006 based on health insurance data suggested one in 72 people was affected with a 62/38 split female to male. This is interesting as previous surveys suggested a much higher incidence in women but it could be that men suffer­ing from the disease are more likely to attract a diagnostic label and treatment within the US health system. Homeopathy & FMS Every patient with FMS has their own story, their own constellation of symptoms, their own trigger factors, their own way of coping with the illness. In this kind of situation, the homeo­pathic approach comes into its own, allowing for the individualisation of a remedy or medicine to match the fea­tures displayed by the patient. As with most homeopathic treat­ment, the medicine may be chosen on the basis of the symptoms of the illness, or on the characteristics of the patient as a whole (constitutional prescribing), or both. Dr Tom Whitmarsh demon­strates a range of approaches in the case studies described later. What is clear is that, as always with homeopathy, the medicine must be individualised to the patient and the case in order to be suc­cessful.These are a few local remedies, which could be considered for people with FMS but be aware that they can only be expected to be helpful if the symptoms match those of the patient well. Rhus tox: this is the rheumatism remedy par excellence and was the rem­edy studied by Dr Peter Fisher in the 1980s and shown to be effective in a double blind placebo-controlled trial of fibromyalgia. It is effective for pain and stiffness which is worse when having been still and gets better for getting moving, particularly bad after overdo­ing things or in cold damp weather, eased by warmth and moderate exercise. It is interesting to note how these match up with the conventional recommendations below! Ruta grav: the remedy picture is sim­ilar to Rhus tox except that the stiffness is, if anything, more marked and less susceptible to improvement with gentle movement. There is often involvement of the tendons or the places where ten­dons meet bone (heels, elbows etc). There is often a bruised feeling. Pains are worse for cold damp weather but without the definite benefit from warmth which is seen in Rhus tox. Rhododendron: the picture is very similar to Rhus tox except that the pains are very much worse for changes in the weather, especially if there is an impend­ing storm or thunderstorm. Arnica: this medicine is best known for its action on injuries to reduce bruis­ing and swelling. However, it is useful whenever the body feels bruised and sore, especially if markedly worse after exertion. A characteristic feeling des­cribed is of “the bed feeling too hard”, in other words, soreness and bruised feeling is worse if the part is lain upon. Arnica can be a good medicine to start treatment of fibromyalgia with, if there is not a clear picture suggesting another medicine at the onset. Hopefully, after a period, a clearer picture will develop.