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Guaifenesin As A Fibromyalgia Treatment Protocol

by Don Gillmore, LMT, RMTI

This article is the result of a recent e-mail question about Fibromyalgia from another therapist and is based on my bodywork experience with several clients. First, I would like to say 'Thank you' to those clients who have educated me about Fibromyalgia Syndrome (FMS) and inspired me to look for answers which could be useful to others.  I am not an expert, but in answering Jane's e-mail, I realized that I had useful information that others could use to help their clients. Others may have information I am not aware of and I would encourage them to e-mail me. I hope the information presented here and on the excellent web sites by Dr. Starlanyl, Ph D. and Dr. St. Amand, MD will be useful to my colleagues and their clients. Please feel free to read the background information in this article along with my e-mail response to Jane or skip directly to the web sites which are linked at the end of this article.

Some of  my early clients only suspected that they had Fibromyalgia and were frequently treated as hypochondriacs by their doctors.  All of the diagnostic tests, of course had turned out negative or inconclusive while these clients continued to suffer from a bewildering array of symptoms which most commonly included, but were not limited to;

    1.   specific and intense pain in an arm, leg, knee, back, hips or other area of the body singlely or all at once
    2.  diffuse whole body aches and pains
    3.  loss of energy, strength, or endurance often accompanied with weight gain
    4.  decreased capacity to concentrate and focus mentally

Some of my clients had actually received the default diagnosis of FMS from their doctors after years of diagnostic tests for everything under the sun, but were told that there was nothing that could help their condition.

Since 1987, FMS has been recognized by the medical community as a valid 'syndrome', which has no known cure, however many doctors still think of FMS as a 'fad' illness. Furthermore, most of the medical community has no idea that there is a simple treatment protocol which has helped thousands manage their symptoms!  You will probably have to educate your doctor or find one willing to prescribe a treatment not pushed by the pharmaceutical companies or 'published' in the medical journals.

E-mail Question

I am working with a client who has Fibromyalgia. Can you help me with specific massage techniques and protocols for this disease?
Best Regards,

My (Expanded) Response

Hi Jane,

Fibromyalgia Syndrome (FMS) is a tough one.  As you probably know, it is sometimes confused with Chronic Myofascial Pain (CMP) formerly called Myofasial Pain Syndrome, which does respond to massage and bodywork therapies. (to view an exerpt from Dr. Starlanyl's book which defines these two syndromes and how they may overlapp, please
click here ).  FMS is a syndrome with no specific triggering event or agent common to all FMS sufferers and it has no known cure or treatment protocol (within the medical community).  Frequently, an active and apparently healthy individual will suffer a severe trauma, which leaves them in pain and a growing list of symptoms for which the doctors have no answer.  The accepted medical diagnostic for FMS, (when all other tests prove negative) is that the client has 11 of 18 predefined tender points sore at the same time.  However, clients frequently have body wide discomfort/pain as well as chronic unrelaxed muscles with many other energy and psychological side effects. Because of the wide range of symptoms (not formally recognized by the allopathic community) that may accompany FMS, each client can be unique. (to view Dr. Starlanyl's extensive list of possible symptoms, please click here ).

I have worked with several FMS clients. Some prefer (and enjoy) deep tissue work especially along neck, shoulders, and back. For these clients deep tissue therapy provided temporary relief and usually a good night's sleep. At least two of my FMS clients were so tender all over that it was difficult to give them any deep tissue work. With these clients, I used swedish massage and energy work.  In most cases, even when massage therapy provided welcome temporary relief, I often doubted that I had been able to make a significant change to the client's chronic unrelaxed muscles.  I am not aware of a massage protocol that is specific for FMS and works with all FMS clients.  Keep in mind that it is possible that your client has Chronic Myofasial Pain which shares many symptoms with FMS or just as likely has CMP trigger points in addition to FMS.

I would highly recommend that you and your client learn about the work of Dr. St. Amand and the use of guaifenesin as a treatment to relieve pain and reduce the amount of chronic unrelaxed muscle tissue.  Three of my clients are currently using guaifenesin (at different dose rates) to manage their symptoms and regain active, happy and productive lifestyles. 
Guaifenesin is used in over the counter decongestants as a bronchial dilator, but your client will need to get a doctor's prescription for it in tablet form that is strong enough to effect the FMS.  Many doctors are unfamiliar with guaifenesin as a FMS treatment protocol and may need to be educated, so here are three web sites with excellent info.

1. by Devin J. Starlanyl, PhD and author of two books considered to be the 'bible' of FMS.  My niece cried when she read the first book, because she had found someone who recognized her many symptoms as part of FMS and not just hypochondria.

2. by Dr. St. Amand, MD, the foremost advocate for guaifenesin as a treatment protocol and the only one to formulate a coherent, but unaccepted theory about FMS's cause.  He has a book and video that explain his theory as well as many of the unrecognized symptoms of FMS and his treatment protocol.  This site also lists FMS support groups around the country.  I highly recommend these as your client will need help in eliminating all trans-dermally and sublingually absorbed salicylates from their life if they choose guaifenesin as a treatment.  He has also prepared a technical medical information sheet for the physician who is being asked to write the prescription

3. a good site with links to several other Fibromyalgia and guaifenesin information and support group sites.

I wish you and your client the best.  Don

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