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Fibromyalgia is the prototype of central pain · Cultural Wars | America Out Loud News

• 0:47
  Good day, everyone.
• 0:48
  You are listening to Unity Without Compromise.
• 0:51
  This is Dr.
• 0:51
  Steve Latoul on the America Out Loud Network.
• 0:55
  Well, as you know, if you've been listening to me, I have been discussing a series on central pain.
• 1:02
  Now, I've been on this topic for several weeks, and so I feel like I can actually say the words now central pain.
• 1:10
  However, I can't normally do that.
• 1:13
  It doesn't matter if I'm going to a medical conference and giving lectures on this, or if I'm talking to someone casually in the community, I can't just bring up the topic central pain.
• 1:25
  And so what I generally do is talk to someone about fibromyalgia.
• 1:31
  And then all of a sudden they get it.
• 1:33
  Oh, yeah.
• 1:34
  Because fibromyalgia kind of typifies, it is the prototype or the stereotypical syndrome that actually defines central pain.
• 1:47
  What is fibromalgia?
• 1:49
  Well, we don't know.
• 1:50
  We don't know where it comes from.
• 1:51
  We don't know how it originates.
• 1:53
  We don't know how it spreads, how it centralizes, and so forth.
• 1:57
  That's that's the line, anyway, the party line that is has been proclaimed.
• 2:01
  And of course, I am here right now to absolutely dispute that.
• 2:07
  But when I explain to people that I understand fibromyalgia because I have treated it for over a couple decades now, um, they get it, they really understand it, and that is because fibromyalgia is the classic prototype that reveals the real agony of central pain syndromes.
• 2:27
  You know, it's just not, it's not just pain alone, but it there's so much that goes with it besides the pain.
• 2:34
  Uh the stress, the anxiety, the insomnia, um, just a lot of symptoms usually, and these symptoms are debilitating, and fibromyalgia tends to capture that, and it captures a lot of other details about what central pain really is.
• 2:53
  And of course, fibromyalgia uh is debilitating as it is, it is still claimed uh to be untreatable.
• 3:03
  And you know, unless it's properly treated, it is a chronic condition, and it does tend to worsen over time.
• 3:13
  And as I saw these patients in my medical practice, I just had a lot of sympathy for them because they are living lives of agony.
• 3:23
  And when you understand that this ailment has tormented millions of patients globally, and thousands of doctors as well, because let me tell you, medical doctors dread trying to treat central pain.
• 3:38
  They hate it because they don't understand it.
• 3:42
  Now, if you go to the National Fibromyalgia Association, that's just one of these support groups online.
• 3:48
  I checked them out, and their estimates say that some 10 million Americans, and they estimate that 3 to 6% of the world population is afflicted by fibromyalgia.
• 4:01
  Now, the truth is I don't know how they come up with those numbers, and I actually suspect that the number of fibromyalgia patients is much higher than is reported because a lot of them don't even know they have it, and it's not categorized in any way.
• 4:17
  When I was writing my book on central pain, I couldn't put it in the category of central pain simply because the category did not exist.
• 4:25
  So I had to define it in a different way.
• 4:29
  But fibromyalgia is affecting a lot of people and it destroys many millions of people's lives.
• 4:36
  It does appear to be more common in women than in men, and there's a reason for that.
• 4:43
  And fibromyalgia also becomes increasingly prevalent with age.
• 4:48
  So the older you get, the more um life tends to beat you up, I guess, uh the more you are prone to developing any central pain syndrome, but specifically fibromyalgia.
• 5:02
  Now, when if you go to Johns Hopkins, uh their website, and um look up John Hopkins on fibromyalgia, they capture the current medical consensus, which I have repeated to you.
• 5:16
  They say there is absolutely no cure for fibromyalgia.
• 5:20
  However, the symptoms can be managed.
• 5:23
  And as I said, I'm here to uh dispel this myth of being incurable.
• 5:30
  That's a bunch of nonsense.
• 5:32
  It is simply not true.
• 5:34
  Anyone can heal from fibromyalgia.
• 5:37
  And today I want to show you how I actually healed hundreds of fibromyalgia patients completely successfully with no relapse, and they were on no medications because they had no more pain, no more symptoms of fibromyalgia, whatever they were, and they can be many.
• 5:56
  Now, if you go to the CDC's website, they will tell you that the cause of fibromyalgia is unknown, and yet they erroneously classify it as quote, a type of arthritis.
• 6:11
  Well, how do they know that if they don't know what causes it?
• 6:15
  Or they don't know what it really is.
• 6:17
  But they call it a type of arthritis, and that is completely wrong.
• 6:21
  It is incorrect, it is not a form of arthritis.
• 6:31
  And it need not be a chronic disorder that follows you to the grave as a as opposed to what they tell you.
• 6:41
  So let me just review the symptoms of fibromyalgia.
• 6:44
  Like migraines and irritable bowel syndrome, fibromyalgia originates from emotional pain gone bad.
• 6:53
  The faulty processing of emotional trauma.
• 6:57
  And like IBS, if you heard my uh my radio show on irritable bowel syndrome, fibromyalgia can manifest in a whole lot of different ways, and it has myriads of potential causes.
• 7:13
  But it derives from a prior unresolved traumatic emotional event.
• 7:20
  It might be physical abuse, sexual abuse, emotional abuse of some sort.
• 7:25
  It could result from the extreme stress of abandonment, say, for example, if your parents divorced at a young age, or maybe a betrayal of a marriage if your spouse was having an affair on you and it was devastating to you.
• 7:41
  Or it might just have been some kind of traumatic loss, like the death of a child or a spouse, or the loss of your health or function due to some kind of an injury or uh an automobile accident.
• 7:56
  Uh, but it there was some kind of a traumatic loss, and uh whatever it was, um it results in this processing of pain, emotional pain that becomes transformed into a widespread pain.
• 8:15
  And most commonly, fibromyalgia does involve a diffuse or widespread pain all over your body.
• 8:23
  My fibro patients that came to me said, you know, I just hurt all over.
• 8:28
  It was hard for them to localize it.
• 8:30
  That pain is usually, by the way, symmetrical, although it does not have to be.
• 8:36
  It also can be limited to only a small region or regions of your body, such as the wrists.
• 8:44
  I recall a patient who was a librarian for her entire life, and she suffered from fibromyalgia that localized mainly in the wrist.
• 8:54
  She had no arthritis, no deformity of her wrists or hands.
• 8:58
  Um, but she just had a small region on either side of the body in the wrist that caused her a lot of pain that worsened with stress, and that's a common factor with fibromalgia.
• 9:11
  So that can happen, and in a sense, it can it can localize to any region of the body.
• 9:19
  And when I talk about region, I'm talking about, like, say, an area of the body that does not jive with or doesn't match up with the nerves that innervate a certain muscle group or certain parts of the arms or legs and so forth.
• 9:37
  It's just a region, and in that sense, it behaves a little bit like complex regional pain syndrome, and I'll be talking about that in detail because that's a real tough one for people, and there's reasons for it being really tough.
• 9:51
  Except that with fibromyalgia, they don't have any prior physical trauma whatsoever that like that does.
• 10:00
  Accompany CRPS.
• 10:04
  And other symptoms associated with fibromyalgia syndrome include things like chronic fatigue, anxiety, and sometimes anxiety is severe.
• 10:16
  They can have severe and usually have severe insomnia, brain fog or difficulty concentrating.
• 10:23
  They have very poor endurance.
• 10:25
  And in fact, if they try to do something physically exerting, they'll pay for it for the next two, three, four days before they recover.
• 10:33
  It wipes them out for a few days.
• 10:35
  And then in general, they tend to have poor coping skills, and always the pain worsens by stress.
• 10:43
  And that can include mental stress or physic and in short, for fibropatients, life is just an absolute struggle.
• 10:54
  Nothing is easy, and they feel alternately like they're in control and out of control, always kind of teetering on the edge, you know, like wondering what is my day going to be like.
• 11:06
  How am I going to survive today?
• 11:08
  And pain usually becomes their main focus.
• 11:13
  So it's a pretty miserable life for these people who suffer from fibromyalgia.
• 11:19
  And that really motivated me in the course of my training myself on fibromyalgia, trying to understand it, trying to make the symptoms go away.
• 11:30
  And it took me a few years to figure it out, but I did figure it out.
• 11:35
  Now, if I was going to define fibromyalgia, I would just call it a physical manifestation of all these symptoms I described.
• 11:43
  The primary uh ailment being pain, that is caused by an unresolved emotional injury, if you will, or pain originating in the limbic region of the brain, the limbic system, which is the emotional processing center of the brain.
• 12:00
  And this results in persistent maladaptive brain changes that transform emotional pain into an actual learned physical pain.
• 12:14
  And then this pain is transmitted through descending pathways to other regions of the body as an actual somatic or bodily pain.
• 12:25
  And this pain is worsened by sensual augmentation.
• 12:30
  And now that's a term that refers to a negative reinforcement that intensifies one's sensitivity to pain.
• 12:38
  So fibromyalgia patients can have an awful lot of pain from things that generally don't cause other people pain.
• 12:49
  It's a hyperalgesia, we call it.
• 12:52
  And the causes of augmentation of this pain or increased sensitivity to pain is uh it results from ongoing or unresolved emotional trauma and perhaps some medications that do cause this, like opioids, like benzodiazepines, that is the absolute curse of medical classes that cause problems, kerasopridol or soma.
• 13:22
  These kind of medications will centralize your pain.
• 13:26
  They will make it worse.
• 13:27
  But also, new stressors can aggravate central pain, such as financial stressors, maybe it's marital stress, or if you have a parent or child conflict that is really tearing you apart, or in this day and age, if you are suffering from just the political tensions that we face every day, you know, that can really wear on some people, especially if you are affected personally by that.
• 13:55
  And then there's things like pressing time constraints, deadlines you have to meet that stress you out, and even regular activities in your daily routine ultimately can become hard to accomplish because of the pain and the fatigue.
• 14:12
  And so what happens is it becomes a vicious cycle.
• 14:15
  And then when your doctor gives you this broken party line that there is no cure, and he and your doctor offers you no hope because the cause of fibromyalgia is unknown.
• 14:30
  We don't know how to treat this, I'll tell you.
• 14:32
  Well, that just adds salt to the negative feedback wound, if you will, resulting in further sensual augmentation.
• 14:41
  And that is not good.
• 14:43
  So who develops fibromyalgia?
• 14:47
  Well, the CDC talks about risk factors.
• 14:50
  Now, I I'm amused by this.
• 14:52
  They describe the risk factors.
• 14:54
  This is the the CDC.
• 14:56
  You go on their website of fibromalgia, and they say the risk factors for fibromalgia are quote, stressful or traumatic events.
• 15:04
  Notice the first thing they list.
• 15:07
  Accidents or injuries, repeat injuries, illness, including viral infections, people age 30 to 50, women, uh, obesity, and people with related conditions, like lupus, rheumatoid arthritis, or osteoarthritis.
• 15:30
  And then, you know, that's inaccurate because lupus is in rheumatoid arthritis and osteoarthritis are not related conditions.
• 15:41
  They are not at all related to fibromyalgia unless the joint pain is itself the emotional trigger.
• 15:52
  All right.
• 15:52
  That's the only way it would be related.
• 15:55
  It is not a related joint or muscle condition.
• 16:00
  And then the CDC, they'll go so far as to call it stressful or traumatic event as a risk factor, but they will never speculate that these events might actually be the cause.
• 16:15
  And this is a common threat I've seen in all the websites, all of the medical websites.
• 16:20
  And I'm not just picking on the CDC or Johns Hopkins or the Mayo Clinic or Cleveland Clinic.
• 16:27
  They all say the same thing.
• 16:29
  Well, emotional pain and suffering, as you know, if you've been alive for a few years, it's a part of life.
• 16:36
  So why doesn't everyone have fibromyalgia?
• 16:40
  Well, because not everyone is the same.
• 16:43
  Everybody has different coping mechanisms, different support systems, different constitutional strengths, faith beliefs, socioeconomic status that can play a part in things because of stress, and we all have different genetics.
• 17:02
  So, and let me tell you this: however strong we may think of ourselves, and we all like to think, oh, yeah, I I got great coping mechanisms, right?
• 17:11
  I can deal with anything.
• 17:13
  Well, you know what?
• 17:14
  We all have a breaking point.
• 17:16
  And we don't know where that is until we are put to the test.
• 17:22
  But we are human beings, and every human being has their breaking point.
• 17:29
  Now, why are women more prone than men?
• 17:31
  I kind of referred to that, hinted at that that there's a reason for that.
• 17:35
  The reason is because the male and female brains are hormonally and structurally different.
• 17:43
  And that's because of genetics, by the way, on the X and Y chromosomes, the sex chromosomes.
• 17:50
  If you're uh created male, you have an X and a Y chromosome.
• 17:54
  If you're a female, you have two X chromosomes.
• 17:57
  And that determines how your brain develops and is shaped and how it processes information.
• 18:06
  And these differences cause the female brain to process emotional pain differently than the male brain.
• 18:15
  It's very simple, and this is pure science.
• 18:18
  But nurture also does play a role.
• 18:22
  Anxious parents tend to have anxious children, for example.
• 18:26
  And both parents and children are prone to fibromyalgia if they tend to have what people would call nervous personalities, you know, an anxious pre uh disposition.
• 18:40
  And then if you look in this day and age, we see a lot more of it.
• 18:43
  Men who are raised to be effeminate, in my experience, they tend to be more prone to fibromyalgia.
• 18:51
  Not all of them, but the patients that I treated, the male patients with fibromyalgia tended to have more effeminate traits.
• 19:02
  It's just something that I saw, and uh it is substantiated in the literature on fibromyalgia, but they don't explain why.
• 19:12
  But we know that men who are raised to be effeminate tend to have more uh of a propensity, a tendency to develop fibromyalgia.
• 19:21
  Um, they the CDC all also mentioned obesity uh as a risk factor, and that might be for a lot of different reasons.
• 19:30
  Primary obesity, meaning you just have a genetic predisposition to becoming obese, um, as some people do have.
• 19:39
  Well, that can be physically and emotionally stressful.
• 19:43
  Obese kids in schools are often bullied all the way through high school.
• 19:48
  Obese people tend to have poor heating eating habits in general, and they are less apt to exercise simply by nature of obesity.
• 19:58
  Obese people are more.
• 20:00
  More prone also to sleep disorders like obstructive sleep apnea.
• 20:05
  It has a significant correlation.
• 20:08
  But secondary obesity, meaning you're just you're obese because you're just overeating, you're not exercising, you're not taking care of yourself.
• 20:17
  That also may be a correlate with certain stressors.
• 20:21
  For example, I I saw many people tend to stress eat, right?
• 20:26
  Oh, I'm so stressed out.
• 20:27
  Give me some chocolate, you know, let me munch on something.
• 20:30
  People who have been sexually abused, and I treated a lot of these people.
• 20:34
  Um, they often try to gain weight to make themselves less attractive.
• 20:39
  And they don't even think about it.
• 20:41
  And then in America, well, we are handicapped.
• 20:45
  We have food addictions like crazy.
• 20:48
  It's very common.
• 20:49
  And many food additives in snack foods like chips and sweets, well, they're present um because they they induce cravings.
• 21:00
  They entice you to eat more than you otherwise would.
• 21:04
  So we're really uh more prone to obesity in America just because it's America.
• 21:09
  You know, if you go back to, I forget what year it was, I think in the early 60s, um, the lay's slogan, bet you can't eat just one, right?
• 21:18
  Fritos, corn chips, potato chips are addicting and fattening.
• 21:24
  And you can take that tagline as an enticement to indulge yourself, or you could say, you know what, warning, warning, yeah, bet you can't eat just one because they make you crave it.
• 21:38
  So I would say stay away from them if you can.
• 21:42
  But I've treated many thin patients who had fibromyalgia as well, and I want to make that very clear.
• 21:47
  So let's not get carried away with the obesity thing.
• 21:50
  No, when you're talking about making a diagnosis of fibromyalgia, doctors obviously struggle to make the diagnosis of fibromyalgia because for one thing, they don't want to diagnose you with it, and you don't want to be labeled a fibromyalgia patient.
• 22:05
  It has negative connotations in our society, mainly because you know, in general, doctors don't understand it.
• 22:13
  And so patients really wish to avoid the diagnosis like a curse because it is a curse.
• 22:20
  And once you get labeled a fibropatient, it gets gets in your chart records, doctors don't even want to take care of you.
• 22:27
  So why is it so hard to make the diagnosis and to accept the diagnosis?
• 22:33
  Well, without a mechanism to describe the central pain pathway of fibromyalgia, making the diagnosis for one thing can be pretty daunting.
• 22:43
  We don't know how to do it as doctors.
• 22:45
  And if researchers themselves are stumped, then you can expect that clinicians are even more stumped.
• 22:53
  They just don't know how to proceed with it.
• 22:56
  I read an article in the Journal of Clinical Medicine, and it addresses the problem pretty clearly.
• 23:02
  It says, quote, the lack of objective markers of the illness that has been a persistent problem in fibromyalgia sim uh syndrome research, FMS research, clinical management and social recognition of the disease.
• 23:18
  It's a big problem.
• 23:19
  We don't know how to proceed.
• 23:20
  In other words, they don't have any idea what they're dealing with.
• 23:24
  And even the CDC gets it wrong, claiming that doctors usually diagnose fibromyalgia using the patient's history, physical exam, x-rays, and lab tests.
• 23:36
  And I think I've already mentioned X-rays and lab tests have absolutely no role in diagnosing fibromyalgia because the tests are always normal.
• 23:45
  Other than maybe ruling out other pathology if you suspect it.
• 23:50
  If I have a 60-year-old patient and I suspect they have fibromyalgia, I have a duty to make sure that there's not other painful syndromes going on that are being caused by other actual pathology.
• 24:02
  But remember that fibromyalgia is a functional syndrome.
• 24:06
  And that means that all objective diagnostic markers will be normal.
• 24:12
  Fibromyalgia syndrome is not a pathological condition that can be discerned by laboratory tests and imaging.
• 24:22
  However, and this is a big but that does not mean that clinicians cannot make the diagnosis with certainty.
• 24:31
  You can very easily if you know what you're doing.
• 24:35
  Now, ironically, the American College of Rheumatology in 1990, way back then, 1990 developed formal diagnostic criteria for fibromyalgia syndrome.
• 24:49
  And I say it ironically because FMS, fibromyalgia, is not a rheumatologic or joint disorder.
• 24:57
  They, the American College of Rheumatology then updated this criteria in 2010 and 2011, and then again they updated it in 2016.
• 25:07
  Now, how accurate would you expect their criteria to be?
• 25:11
  They're calling it a joint disorder, and it's not.
• 25:15
  They don't know what they're talking about.
• 25:17
  Now, unfortunately, Western medicine doctors need hard data to make a diagnosis.
• 25:25
  That's one of the flaws of Western medicine.
• 25:27
  Doctors need tests, and even more so now because we live in the age when thorough history taking and physical diagnosis, they're downplayed in medical schools.
• 25:41
  The physical exam is a lost art.
• 25:44
  The new shotgun approach to medical diagnosis, well, what do they rely on?
• 25:50
  They rely on diagnostic lab tests, MRIs, CT scans, and other invasive procedures like tissue biopsies, nerve conduction studies, you know, the electromyelograms.
• 26:05
  They can, and none of these tests can diagnose fibromyalgia.
• 26:09
  They make the doctors in the hospitals a ton of money, but they are have no place in diagnosing fibromyalgia.
• 26:17
  And so, you know, their presumption is if there's no physical diagnosis that is documented, uh backed up by hard data, such as these procedures, then there must be no cure.
• 26:31
  And that's the conclusion they come to.
• 26:34
  But they make lots of money on the misdiagnosis.
• 26:39
  The National Institute of Arthritis and musculoskeletal and skin diseases, they have a say on this whole thing.
• 26:49
  And they can only define fibromyalgia as, quote, a chronic long-lasting disorder that causes pain and tenderness throughout the body, end quote.
• 27:01
  And then they say it results in fatigue and insomnia.
• 27:06
  Then in this article that I read, they admit the scientists have no real idea what causes it.
• 27:12
  And they conclude only that fibromyalgia patients seem to be more sensitive to pain compared to those without fibromyalgia.
• 27:23
  Then they chime in with the common mantra, and that's where they go.
• 27:26
  There is no cure for fibromyalgia, they say.
• 27:30
  And that is such nonsense.
• 27:33
  But where do we go from here?
• 27:37
  Where do we go then?
• 27:39
  If it's hard to diagnose, there's no real effective criteria, they're always changing it.
• 27:46
  They're they're changing the codes, the billing codes for central pain syndrome, because they don't know what that really is.
• 27:53
  It's more inclusive now, and they seem to be getting closer, but they just don't know where to go with it or what to do with it.
• 28:03
  Well, I'm going to get a little more clear after a short break, and I'll tell you what to do with it.
• 28:11
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  We are sorting things out.
• 33:39
  We sometimes change our minds, change our views, but we are seeking the truth and only the truth.
• 33:46
  And I think that's one of the greatest strengths of this network.
• 33:50
  So I hope you'll join us for the great celebration, America Out Loud 25010.
• 33:56
  It is going to be a memorable event where some phenomenal patriots are going to gather.
• 34:03
  I will be there.
• 34:04
  I already have my tickets and uh my reservations for the hotel.
• 34:09
  It's going to be a fabulous time, and it's going to go off for the bang at the end with the great fireworks celebration that they have there.
• 34:17
  I'd also encourage you, please, if you have not read my book, Pain Free and Living Again, How to Heal Fibromalgia, IBS Migraines, and Other Mystery Pain Syndromes.
• 34:28
  I want you to put me to the test.
• 34:30
  I have figured this stuff out.
• 34:33
  It is impossible, however, for me to publish in the medical journals.
• 34:38
  I tried hard getting um my research data out there.
• 34:42
  I tried publishing case studies, they would not let me do it.
• 34:46
  And that's because of the hijacking, not just of medicine, but also of the medical publications and medical research, which is a real shame.
• 34:56
  So if you want to really figure out your central pain, whatever it may be, IBS, fibromyalgia, migraines, complex regional pain syndrome, bladder pain syndrome, whatever it is, um, you'll walk away with a phenomenal understanding.
• 35:11
  You'll know uh much more about central pain than uh the great majority of medical doctors in America and all others.
• 35:18
  So I encourage you, uh, check it out.
• 35:20
  And if you like the message, please pass it on.
• 35:23
  Please leave me a review because that's what really gets the book out there.
• 35:27
  I am not seeking to make any uh financial gain on this book.
• 35:33
  I just want to get the word out.
• 35:35
  And um I'm still going to do my best to get a central pain network of physicians, medical doctors, clinicians, because right now we have a tremendous shortage of doctors that can actually treat it because they don't understand it.
• 35:50
  And so if you're wanting to get treated, you might actually have to take my book in and say, hey, Doc, would you please read this so that we can talk the same language?
• 35:59
  And if you can do that, then you're gonna get some help.
• 36:02
  And that's very important.
• 36:05
  Well, let's get back to it.
• 36:07
  Since fibromalgia exit exhibits itself, manifests in so many different ways and with so many symptoms, you can imagine that diagnosing and treating it can be pretty baffling, can be very challenging.
• 36:26
  Um, to diagnose it, well, you just have to look first for the that significant emotional traumatic event.
• 36:33
  And I'm telling you, it's there.
• 36:35
  You might have to go back 10, 20, 30 or more years, 50 years back.
• 36:39
  But it's there.
• 36:41
  If your brain processes that emotional pain in a faulty way that does not achieve resolution of the trauma, even if you repressed it way in the back of your brain, oh yeah, I just put aside my traumatic childhood.
• 36:58
  I don't think about it, I won't let myself think about it.
• 37:01
  Well, that could be affecting your life in a very huge way in a very unhealthy way.
• 37:06
  Because if your brain processes that emotional pain in a faulty way that does not achieve resolution of the trauma, it is likely going to be centralized.
• 37:17
  And if your pain is centralized in whatever way it manifests, migraines, IBS, fibromyalgia, it is going to stay there forever.
• 37:28
  So if you're feeling a gruesome heartache, that pain can feel much worse than physical pain, and it can have dire consequences.
• 37:38
  If not resolved, it can cause the pain all over of fibromyalgia.
• 37:43
  If your pain is localized to a specific region, then you want to think about a possible connection.
• 37:52
  Why if I have IBS?
• 37:53
  Why IBS?
• 37:55
  Why fibromyalgia?
• 37:57
  Why female pelvic pain or bladder pain syndrome?
• 38:01
  So you want to think in those terms.
• 38:03
  When I was treating this librarian that I mentioned earlier, I treated uh her for multiple stressors that she had been going through in her life, but she mentioned that she was just tired of picking up books day after dreaded day, year after year.
• 38:21
  And she told me that being a librarian became drudgery to her.
• 38:26
  She was just tired of her job.
• 38:28
  So while she had these widespread tender points elsewhere as well, um, the points of greatest tenderness were actually her wrists and hands in a regional distribution, and that's not physiologic.
• 38:42
  It's not normal.
• 38:44
  It was not just a specific joint uh because of joint pathology, in other words, it was muscles that were aching, not joints.
• 38:53
  And as emotional pain of a general nature is relived every day, well, your brain processes this through reactive asterocytosis.
• 39:03
  That is my presumptive theory, and it may transmit this mob modulated emotional pain in a way that is located nonspecifically.
• 39:16
  Its location, therefore, is non-specific.
• 39:18
  So you say, hey, I'm hurting.
• 39:20
  I hurt all over.
• 39:22
  And it spreads throughout your body.
• 39:24
  So this results in a generalized hypersensitization of pain receptors in your body.
• 39:31
  And all you can say is, I hurt everywhere.
• 39:37
  Well, this kind of pain is very fatiguing itself, and fatigue is a big part of fibromyalgia, chronic fatigue.
• 39:44
  And it reduces sleep quality and makes falling asleep hard and staying asleep even harder.
• 39:51
  You can roll over and have pain, and this results in further dysfunction, of course.
• 39:56
  If you can't get a restorative night's sleep, you don't.
• 40:00
  Achieve the necessary sleep nourishment, if you will, and you're going to have terrible coping skill skills.
• 40:09
  You will not be able to cope with stressors.
• 40:11
  And you see where this is going.
• 40:13
  You know, that in turn leads to more physical pain.
• 40:16
  And it just becomes a negatively reinforcing cycle.
• 40:22
  It leads to more emotional pain because you're told, hey, I'm sorry, it's nothing we can do about this.
• 40:29
  And that in turn leads to more physical pain until you get to the point that even a gentle hug can physically hurt.
• 40:39
  Patients have told me that.
• 40:41
  I tell my husband, don't hug me, don't hug me because I hurt too much.
• 40:46
  And this pain that they're feeling is real pain.
• 40:50
  It's not all in your head.
• 40:52
  It's not something they're making up.
• 40:54
  It is real.
• 40:56
  And then you get labeled a fibromyalgia patient.
• 41:01
  Whoa.
• 41:03
  That's terrible.
• 41:05
  It's usually the third manifestation, fibromyalgia in the central pain cascade after migraines in IBS.
• 41:15
  And doctors, if you recognize this pattern, it can help you to make the diagnosis.
• 41:21
  If someone already has migraines and IBS, you should be asking about fibromyalgia because that is usually what appears next.
• 41:30
  It doesn't have to appear next, but it was a common trend that I saw.
• 41:34
  So how do you treat fibromyalgia syndrome?
• 41:37
  Well, first, it requires a thorough history, and I've talked about this in the past.
• 41:42
  But you need to go deep into the social history.
• 41:45
  Does this person have any drug abuse, any personal abuse history, whatever it may be, sexual abuse, physical abuse, spiritual abuse, emotional abuse?
• 41:56
  And what medications are they taking, including over-the-counter medications, supplements?
• 42:01
  You have to consider the general health of this person, the body habitus, the patient motivation.
• 42:07
  Are they motivated to change?
• 42:09
  How is their sleep quality?
• 42:11
  Are they exercising?
• 42:12
  Do they do anything for exercise?
• 42:14
  Do they have current stresses?
• 42:16
  Are they suicidal?
• 42:18
  Do they have any present degree of severe anxiety or depression?
• 42:24
  How is their support system?
• 42:26
  And what's the patient's willingness to change medications and to change their lifestyle as prescribed?
• 42:33
  Are they willing?
• 42:34
  And you also have to consider other coexisting central pain conditions.
• 42:39
  And you've got to keep in mind that the differential diagnosis of all pain.
• 42:43
  In my medical practice, I treated every kind of pain there was.
• 42:47
  All concurrent disorders must be identified.
• 42:50
  Unlike any other types of pain, central pain requires a comprehensive evaluation of a unique human being and their entire life.
• 43:04
  Detailed without shortcuts, no rocks unturned.
• 43:08
  You got to get to the root cause.
• 43:11
  But the time spent on this accurate and thorough pain analysis is invaluable in restoring a quality of life for a patient.
• 43:23
  The history taking itself is almost always therapeutic.
• 43:29
  I found that to be the case.
• 43:31
  That's when the healing actually first began with central pain patients.
• 43:37
  As I was taking their history, because they started thinking about things and making connections.
• 43:42
  It lays the groundwork for healing.
• 43:46
  It helps the patient connect the dots.
• 43:49
  It instills confidence as well.
• 43:52
  And it gives the patient hope.
• 43:55
  And that's just what they need.
• 43:57
  Since fibromyalgia has a wide array of presentations, and since it's usually associated with other central pain syndromes, its treatment can seem really complex.
• 44:08
  You could be dealing with dozens of symptoms.
• 44:12
  So let me simplify it for you by breaking it down.
• 44:16
  And this worked for every fibro patient that I ever treated, regardless of how many symptoms they presented with.
• 44:25
  So what I started with, and you know, let them talk about their symptoms.
• 44:31
  I could write down document 20, 25, 30 symptoms.
• 44:35
  Do you have this or that?
• 44:36
  Yeah, yeah, yeah, I got everything.
• 44:38
  Okay.
• 44:38
  Well, the central pain, primary symptom triad will break it down.
• 44:44
  And these are pain, anxiety, and insomnia.
• 44:48
  And I would draw a triangle for them, and I'd say of these three symptoms, pain, anxiety, insomnia.
• 44:57
  Where are you in this triangle?
• 45:00
  And I have those words at the apex uh or at the vertex of the triangle, each corner of the triangle.
• 45:08
  Show me which is the predominant, or if they were all equally bothersome, they'd put a dot right in the middle of the triangle.
• 45:16
  And based on what they put there, that would determine how I would start the initial treatment.
• 45:25
  Treating these primary symptoms in treating them well with the appropriate medications for the initial phase of treatment is very important.
• 45:38
  The quote appropriate medications, in quote, should be well tolerated.
• 45:45
  They should be inexpensive, and they should be efficacious, meaning they do the job.
• 45:51
  It should control the primary symptoms well.
• 45:55
  Now, I want to give you a disclaimer.
• 45:58
  This is not medical advice that I'm giving you because I don't know you.
• 46:02
  I'm not taking your personal history, I'm not doing a physical exam on you, and I'm not recommending a treatment because I don't know you.
• 46:11
  But this is how I did it.
• 46:14
  How I made fibromyalgia go away permanently and stay away.
• 46:20
  I had a three-step recovery plan, and this is the same for all other central pain syndromes.
• 46:26
  And I started this three-step recovery plan simultaneously at the same time.
• 46:34
  But the first thing I had to do was win the confidence of the patient because let me tell you, they they've been told anything but they're going to get better.
• 46:45
  They doubted me when they came to me as the umpteenth doctor in their life, some of them ready to pull the trigger saying, You're my last ditch effort.
• 46:55
  I heard about you.
• 46:56
  Okay.
• 46:57
  So step number one, let's get to it.
• 46:59
  I say, you want to get better?
• 47:01
  Let's do it.
• 47:01
  First of all, you got to stop the wrong medications.
• 47:04
  I actually screened my patients ahead of time because if they weren't willing to stop the wrong medications, then there's no sense coming to my practice.
• 47:12
  Don't waste your time, don't waste my time.
• 47:14
  But generally speaking, the more specialists that these patients saw, the more medications they were prescribed.
• 47:22
  And so they needed to be taken oftentimes, or they need to be taken off a lot of medications.
• 47:28
  Some of them, however, I was surprised at how many patients took themselves off medications.
• 47:34
  They said it wasn't doing anything for me.
• 47:36
  I said, good for you.
• 47:37
  Make it go away.
• 47:38
  And keep in mind when we're stopping some of these medications, some of them might need to be tapered.
• 47:44
  Okay, and there are different categories of the wrong medications.
• 47:47
  I mentioned it before, I'll repeat it again.
• 47:49
  Any medication that offers no apparent benefit, get rid of it.
• 47:54
  If it causes unwanted unwanted side effects, get rid of it.
• 47:58
  If it is very expensive, you can't afford it, make it go away.
• 48:03
  If it has limited benefit, well, I think this might be helping me somehow.
• 48:07
  I'm not sure get rid of it, okay?
• 48:09
  And if it's contraindicated, meaning you should not be on it because of some other medical condition you have, or it's if it's dangerous or harmful, and there are dangerous and harmful medications that are prescribed all the time by medical doctors.
• 48:24
  Well, these should be stopped as soon as possible.
• 48:27
  But if you're on benzodiazepines, they are always, by the way, the wrong medication.
• 48:33
  They are always harmful, they are always dangerous, they will always worsen central pain.
• 48:38
  100%.
• 48:39
  I never prescribe benzodiazepines.
• 48:43
  But these have to be tapered if you're on them.
• 48:46
  And you know, so these medications include prescribed medications, but also over-to-counter supplements, nutritional supplements, vitamins, minerals.
• 48:56
  Keep in mind that many medications that have an FDA indication, and we have a few of them to treat fibromyalgia, may not actually be the best medications for the condition.
• 49:09
  In fact, I found out that they weren't.
• 49:12
  Such drugs as pregablin or lyrica, milnasopran or Cvella, and diloxetine, cymbalta.
• 49:20
  These were indicated to treat fibromalgia.
• 49:22
  I found out I even tried them a little bit.
• 49:25
  I found out they were not the best medications for a number of reasons.
• 49:29
  One of them being it's hard to get patients off of them.
• 49:32
  But they were not as effective as some of the older medications, and I'll get into those.
• 49:38
  Non-steroidal anti inflammatories, ibuprofen, neproxin, leave, aspirin, these do not treat central pain.
• 49:45
  They're worthless.
• 49:46
  So get rid of them if you're taking them for central pain.
• 49:52
  The goal is just to minimize the medications.
• 49:55
  And then numbers two step number two, start the right medications.
• 50:00
  And these serve as a bridge to just get you from point A to point B.
• 50:05
  I used medications that were inexpensive and they tended to be the older medications that were the best.
• 50:14
  For example, ametryptine, one of the first tricyclic antidepressants, worked well.
• 50:20
  If I if somebody came to me and said, I can't sleep, I have pain, and I have a lot of anxiety, ametrypline treats all three.
• 50:27
  This is an example.
• 50:28
  One medication treats a lot of things.
• 50:31
  Venlifaxine or effects or that's an older SNRI and class medication, antidepressant.
• 50:39
  It worked very well for central pain, for treating central pain.
• 50:44
  As did other medications, a muscle relaxed called orphanodrene.
• 50:48
  It was very good.
• 50:49
  Now Trexone, believe it or not, not the very, very ultra low dose naltrexone, 25 or 50 milligrams.
• 50:56
  I use that as well as topiramate, which is an anti-seizure class medication.
• 51:03
  And I used Tramadol if it if pain was the overriding symptom of fibromalgia.
• 51:09
  If it if pain was just destroying your life, that was the number one thing.
• 51:13
  This is the one exception to my opioid rule because they now classify tramadol as a schedule for opioid.
• 51:21
  It has opioid-like properties, but it's very, it's different from other opioids.
• 51:26
  It's not like hydrocodone.
• 51:28
  But since it has some mild opioid-like properties, they label it a schedule for controlled substance.
• 51:36
  Um, but there's others.
• 51:37
  Propanolol, a very early beta blocker to treat blood pressure.
• 51:42
  It is an incredible medication, especially for severe anxiety for panic disorders and things like that.
• 51:48
  Clonidine was incredible, and I use that to help people to get off the benzodiazepines and opioids.
• 51:55
  It's great for withdrawal symptoms.
• 51:57
  So, you know, and I could go on and on with a few other medications, but I'm going to avoid an in-depth discussion on these just because I don't have the time to discuss all of these, but there is a right and a wrong way to prescribe them as well.
• 52:13
  And doctors do not understand the prescribing schedule for central pain.
• 52:19
  It is different.
• 52:20
  For example, you can prescribe some medications every six hours as needed.
• 52:24
  Well, that's not going to get it for fibromalgia or any other central pain.
• 52:30
  You got to know how to prescribe the medication.
• 52:33
  And then step number three, train the brain.
• 52:37
  This is where the healing truly takes place.
• 52:40
  It involves a whole lot more than just some therapeutic lifestyle changes, which are important, and I've spoken about them already, such as good nutrition, sleep hygiene, regular low impact exercise.
• 52:53
  And I'm going to get to more of this training the brain a little down the road because I want to really cover it well.
• 53:00
  I don't, I'm not going to discuss it right now because it applies to the healing of all forms of central pain.
• 53:07
  And it's important that you understand it.
• 53:10
  I don't want to just rush through it, but I'll say this.
• 53:13
  And this is where Western medicine most consistently and most severely fails us.
• 53:21
  It's important to consider all aspects of the whole person.
• 53:27
  Everything that makes us humans should be harnessed in the process of healing.
• 53:32
  And it isn't just the physical you or the mindful you or whatever you want to call it that generates healing.
• 53:39
  You got to deal with the whole person, the human being.
• 53:42
  Medications don't heal maladies in and of themselves.
• 53:46
  They allow the body to heal itself.
• 53:48
  They enable it.
• 53:49
  Healing doesn't only involve the ailing body.
• 53:53
  It's much more than that.
• 53:55
  So I'll leave it at that for now, but I will be talking in detail about training the brain.
• 54:01
  Once you stop the wrong medications and you start the right medications, and only for a time, and then you train the brain, it takes about three months to recovery.
• 54:13
  Sometimes longer if someone's on really high doses of opioids or benzodiazepines, and I've had people really on high doses of these, and you can't stop benzodiazepines uh immediately because they could kill you.
• 54:28
  I could put give you a seizure, and you know, you could you could aspirate, you could die.
• 54:34
  The withdrawals of benzos are wicked.
• 54:36
  You got to do it the right way.
• 54:37
  But if you're taking these, and my, you know, as long as you take these medications, benzodiazepine, I will tell you this, you'll never, never recover.
• 54:46
  You gotta make it go away.
• 54:47
  It's a hard truth to swallow for those of you who are chemically dependent on these medications, but getting off benzos is tough, and I get that.
• 54:55
  And I use uh bridging medications to help with that, but you got to realize that healing does not begin until the benzos are stopped.
• 55:05
  It is the same with high dose opioids.
• 55:07
  And I prescribed opioids uh of different types for chronic pain, but let me tell you, high dose, oxycodone, methadone, hydrocodone, hydromorphone.
• 55:18
  I don't care what the opioid is, if they're in a high dose, you're being not treated correctly for any type of pain.
• 55:26
  So they must be tapered even for somatic pain if they're megadosed.
• 55:31
  It you're going down the wrong path.
• 55:33
  There are ceiling doses, I'm not going to talk about that.
• 55:35
  I'm just about out of time.
• 55:37
  But let me conclude with this.
• 55:39
  Fibromalgia is not incurable.
• 55:43
  That is an absolute myth.
• 55:45
  I want you to understand that fibromalgia is treatable.
• 55:49
  I have consulted with patients many, many times.
• 55:53
  I've helped other doctors to treat their other patients, and guess what?
• 55:57
  They get better.
• 55:59
  Anyone can heal from fibromalgia.
• 56:02
  And I say that with full confidence.
• 56:06
  You can't argue with success.
• 56:09
  So I want that to be your encouragement today.
• 56:12
  Go on living, live uh every day like it's your last, because it could be.
• 56:17
  Remember that life is a gift, and it is from God.
• 56:22
  And when you live your life to the fullest, and with genuine good purpose, you're giving that gift back to God in a special way.
• 56:31
  Thanks for joining me today.
• 56:33
  You've been listening to Unity Without Compromise with Dr.
• 56:36
  Steve Tour.