Where should you start if you are living with Fibromyalgia?
I hope this website, podcast, book, and blog can be a trusted compass to help guide you on your journey to live better with Fibromyalgia. This is whether you are newly diagnosed or whether you have been diagnosed decades ago. I have had the lifetime perspective of a pediatrician, an internist (doctor for adults), a lipidologist (cholesterol expert), and a lifestyle medicine physician caring for those living with fibromyalgia and related problems. I use an evidence-based approach combining the best of medical management with lifestyle medicine.
Co-occurring Health Conditions
Did you get diagnosed but not given any confident guidance on how to live well with fibromyalgia? If you have you are like most. The second most common diagnosis a rheumatologist makes is fibromyalgia, but because it involves the central nervous system and not the classic inflammatory illnesses that are treated by rheumatologists( although many with inflammatory conditions have fibro as well) most are deferred back to your primary care doctor who doesn't feel comfortable treating you or are referred to a pain clinic that often involves more of a medical model of acute pain management offering epidural injections for herniated discs for example. The only other options most find are in the alternative medicine world that may offer treatments that are not always evidence-based. This website, book, podcasts, and blog hope to help fill a needed void.
Treating people with Fibromyalgia epitomizes the art of medicine more than any other.
It starts with a careful history that is comprehensive and longitudinal, taking careful consideration of the bio-psycho-social-spiritual model to help bring in the multidimensional aspects of each unique human creature. I encourage writing your journey back to childhood, outlining in 5-year increments. I have an outline to use as a guide to help you organize this.
Evaluate for severe conditions like metastatic cancer that can cause fatigue and pain.
Diagnosis is using the Widespread Pain Index and Symptom Severity Score. Go to these episodes to learn more.
Assess the Severity of your Fibromyalgia using the FIQ-R, Revised Fibromyalgia Impact Score. Most people with FM mask their symptoms and severity. The FIQR does a more comprehensive assessment and is invaluable in assessing treatment interventions. Go to Episodes How bad is my Fibromyalgia to learn more.
Assess for co-occurring conditions that can intensify symptoms.
Implement evidence-based medical and lifestyle treatments for Fibromyalgia and co-occurring conditions. This approach is individualistic, and while general themes apply to many, each individual should be carefully listened to to help decide what interventions are more likely to be helpful because this involves multifaceted treatments. When medications are used, starting at the lowest dose and calibrating the dose to give optimal benefit with the least side effects is best. Lifestyle treatments are as effective as most medications but must be implemented carefully and scientifically. Close follow-up is important.
Autism, ADHD, and Fibromyalgia Presentation for the Fibromyalgia Community Conference 2023
Fibromyalgia and sleep at the Fibromyalgia Community Care Conference 2022
What are Fibromyalgia Related Conditions?
Fibromyalgia is the classic nociceptive illness. Nociceptive is the updated term used to describe illnesses that have pain without tissue damage or injury or are amplified compared to the extent of the damage.
The mechanisms that underlie this type of pain are not entirely understood, but it is thought that augmented CNS(Central nervous System) pain and sensory processing, and altered pain modulation play prominent roles. The symptoms observed in nociplastic pain include multifocal pain that is more widespread or intense, or both, than would be expected given the amount of identifiable tissue or nerve
damage, as well as other CNS-derived symptoms, such as fatigue, sleep, memory, and mood problems. This type of
pain can occur in isolation, as often occurs in conditions such as fibromyalgia or tension-type headache, or as part of a mixed-pain state in combination with ongoing nociceptive or neuropathic pain, as might occur in chronic low back pain. It is important to recognize this type of pain since it will respond to different therapies than nociceptive pain, with a decreased responsiveness to peripherally directed therapies such as anti-inflammatory drugs and opioids, surgery, or injections.
Overlapping Pain Conditions ="Fibromyalgia Related"
Chronic Fatigue Syndrome, POTS, Chronic Bladder Pain, Irritable Bowel Syndrome, Disorders of the Gut-Brain-Interaction, Migraines, Chronic Tension Headaches, Chronic Back Pain, TMJ, Ehlers Danlos, Long Haul COVID, and Chronic Pelvic Pain
Inform, Inspire, and Equip.
Many people have either been told or read that fibromyalgia isn't real or that it is just all in their heads. This misunderstanding, unfortunately, causes harm and is a disservice to those suffering. If you are one of the estimated 10 million people in the United States who are suffering from fibromyalgia, then you know it is real. If you don't have FM, you will, at a minimum, gain a deeper understanding of what you or your loved one is experiencing. If you do have FM, you will feel validated for what you are enduring. You will also receive actionable steps to thrive, not just survive with FM and its related problems. You will also learn practical and realistic strategies for conquering your fibromyalgia.
Joel L. Young, MD is the Medical Director and Founder of the Rochester Center for Behavioral Medicine. Dr. Young is certified by the American Board of Psychiatry and Neurology with added qualifications in geriatric, forensic, and adolescent psychiatry. He serves as a Clinical Associate Professor of Psychiatry at the Wayne State University School of Medicine. He is also Chief Medical Officer of the Clinical Trials Group of Southeast Michigan. He has served as the primary investigator for more than 70 clinical trials, authoring over 100 articles. He has also authored books on chronic fatigue, mental illness, substance abuse, and ADHD. In addition to clinical care, research, and teaching, Dr. Young also collaborates with the NFL and MLB to evaluate professional athletes.
"Conquering Your Fibromyalgia is an essential contribution that should be devoured by people who have fibromyalgia and by physicians who treat them. At least four million people in the United States suffer from fibromyalgia (FM), a syndrome encompassing varying and fluctuating levels of pain, fatigue, and sleep disturbances in addition to major difficulties with memory and concentration. There is scant understanding of the condition and certainly no unified approach to treatment. Most people with FM face resistance from skeptical doctors many of whom are convinced that FM is a fictional disorder endorsed by individuals seeking to obtain disability or have other nefarious motivations. Even sympathetic clinicians struggle to find meaningful and long- lasting treatments that improve their patient’s sense of well- being and daily functioning. In his book, Dr. Lenz describes the endless obstacles encountered by many FM patients. This labyrinth needs to be deconstructed as it leads to patient and physician frustration and subjects too many FM sufferers to unnecessary procedures and dangerous medications. Beyond reviewing the growing literature regarding the use of non-opiate central acting medications for FM, the author endorses a holistic approach combining with exercise, medication, healthy sleep and thoughtful nutrition. Lenz is at his best when describing the role of a plant-based diet in this complement. These are the sections of the book without peril. Conquering Your Fibromyalgia is a unique addition to the literature and knowledge about fibromyalgia. I am eager for patients and their providers to integrate this well weaved and highly researched book. Internists, family doctors, and pediatricians, as well as specialists such as rheumatologists, orthopedic surgeons, neurologists, and psychiatrists will be enhanced by the author’s mastery. In years past, depression was often ignored as a “real” problem until finally the medical community acknowledged that this mood disorder is a valid problem affecting million and needs to be treated. Now it is time for physicians to step up and realize fibromyalgia is a similarly debilitating medical problem that strongly merits diagnosis and treatment. Conquering Your Fibromyalgia is an important contribution to bringing both doctors and patients up to speed on this profoundly serious problem today, offering them helpful solutions to their perplexing problem."
Dr. Neal Barnard is an adjunct associate professor of medicine at the George Washington University School of Medicine in Washington, D.C., president of the Physicians Committee for Responsible Medicine, and a New York Times bestselling author of 18 books and more than 80 scientific publications. In 2003, he was funded by the National Institutes of Health to test the benefits of a plant-based diet for Type 2 diabetes. His practice focuses on diabetes and other metabolic problems, quantifying the power of nutritional interventions in research studies that have been cited by major medical organizations and the U.S. government. He became a fellow of the American College of Cardiology in 2015, and received the Trailblazer Award from the American College of Lifestyle Medicine in 2016. Find him on Facebook and Instagram.
“This book will provide hope for anyone who is struggling with fibromyalgia. Dr. Michael Lenz provides a comprehensive look at this challenging disease and shares practical tips that can help, highlighting the benefits of a healthful plant-based diet.”
Dr. Heather Toth has a broad background in internal medicine, pediatrics and medical education. Dr. Toth joined the Medical College of Wisconsin in 2001 for internship and residency and served an additional year as chief resident. Her combined training in both pediatric and adult medicine promotes the ability to care for patients whose illnesses and diseases may span several decades. She is honored to remain at the Medical College of Wisconsin in both the department of medicine and the department of pediatrics as an associate professor and a hospitalist for internal medicine and pediatrics. She truly enjoys her career and looks forward to the opportunity to coordinate care, educate and serve others to improve the health of patients and their families.
“Love the title and an extremely helpful resource for patients, families, and providers with real world case scenarios and practical tips! Validates the fibromyalgia diagnosis and shares helpful take- home messages. Easy to read and understand, would share with anyone suffering from fibromyalgia type symptoms, their loved ones, and providers.”
Dr. Michael Lenz has changed the lives of our family. My 17-year-old son has been suffering from Fibromyalgia for over three years. However, we didn't know it was fibromyalgia until about one year ago. And, to add to that, I'm a pharmacist who initially, even after he was diagnosed with Fibromyalgia, was in denial. My pharmacist training, and just being a father, was set on finding an exact cause of what was going on with my son and fixing it. My son was very active in sports and outdoor activities for much of his life. However, our journey began after a football injury to his lower leg in 8th grade. He was complaining of general pain, not just in his leg but his whole body. He was having trouble focusing at school. He was becoming depressed and frustrated that he was not feeling any better. To summarize our experiences, I will list the types of doctors, specialists, and procedures we tried: 1 MRI of the injured knee 2)Trip to Children's Hospital to have a bone biopsy done to rule out cancer 3)Lyme disease test 4) visit to pediatric rheumatology 5) diagnosis of hemochromatosis 6) visit to children's Hospital again with a genetic doctor who made the diagnosis of fibromyalgia 7) visit to pediatric cardiology 8) visits to the chiropractic 9)visits with pediatric psychology 10) mental health therapy. Overall, almost every test came back normal. There was no explanation for why he was feeling the way he felt. Buying Dr. Lenz's book was life-changing as it was like it was telling our story exactly. As a result, my son was diagnosed with comorbid ADHD as well, which I was also in denial of as a pharmacist because my son, up until recently, has always performed well in school and didn't have symptoms of hyperactivity, etc. However, starting treatment for this has drastically improved his overall general health. I'm happy to say that we are optimistic that our son will continue to improve. I can't thank Dr. Lenz enough for doing so much research on this severely under-recognized condition. His podcasts, as well as his book, are full of useful information to help all patients who are suffering from this complicated and frustrating condition. As a fellow healthcare professional, this experience has greatly impacted my views and treatment options for this condition. Thank You, Dr. Lenz, for your dedication and expertise in helping to share your important and evolving information with all patients.
I've been suffering with symptoms for years and was recently diagnosed with Fibromyalgia. I was handed a pamphlet and told that there wasn't much I could do and to go back to my primary care doctor for further help. My primary care doctor who knew nothing about fibromyalgia and was the one who sent me to the specialist in the first place? Yep, that one. Needless to say, I was on my own. I began researching and studying everything I could find. Then I found this book! All I can say is WOW. The clear explanations, the easy to read format, the suggestions and most of all, the compassion... Dr Lenz hit the nail on the head. This book is a must read for everyone who has fibro, who knows someone who has fibro or who works in the medical profession. I was without hope until I read this book. Now, I feel like I am not alone and have hope for the future.
Thank you Dr Lenz.
If you are suffering from unexplained pain and haven't found answers, Dr. Lenz's book provides credible insight into why you feel this way and how to find relief.
You will find yourself identifying with the information he provides.
What is lifestyle medicine?
Lifestyle medicine is a medical specialty that uses therapeutic lifestyle interventions as a primary modality to treat chronic conditions. This includes type 2 diabetes, heart disease, and obesity but also is very helpful for chronic conditions like fibromyalgia and related problems like irritable bowel syndrome and headaches, for example. Lifestyle medicine uses a evidence-based, whole-person, prescriptive lifestyle change to treat and, when used intensively, often reverse such conditions. Applying the six pillars of lifestyle medicine—a whole-food, plant-predominant eating pattern, physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connections—also provides effective prevention for these conditions.