Making Sense of Fibromyalgia and Chronic Pain

…a tidal wave of chronic illness…

The New York Times – September 9, 2009

That’s what med­ical stu­dents expe­ri­enced when they spent a sum­mer observ­ing the real-world envi­ron­ment of com­mu­ni­ty med­ical prac­tice:  “A tidal wave of chron­ic ill­ness” over­whelm­ing patients and the over­worked doc­tors try­ing to help.

How can you find your way through the chaos of chron­ic pain or anoth­er long-term ill­ness and re-emerge with a healthy future to look for­ward to?

It won’t be easy.

Dr. Jef­frey Moss is one of the nutri­tion author­i­ties I turn to to learn more about the caus­es and treat­ment of chron­ic ill­ness.  He offers exten­sive edu­ca­tion­al mate­ri­als for doc­tors – includ­ing newslet­ters, web post­ings, and sem­i­nars.  He’s con­stant­ly comb­ing through the moun­tains of research on nutri­tion and chron­ic con­di­tions.

There’s an “expand­ing group of chron­i­cal­ly ill patients tru­ly becom­ing a “500 pound goril­la in the room” in that, despite being treat­ed repeat­ed­ly for their ill­ness­es, they rarely “get bet­ter.”  In con­trast, they receive an end­less amount of treat­ments for the ongo­ing acute exac­er­ba­tions of their relent­less, nev­er end­ing, ever expand­ing list of chron­ic ail­ments that form “a ball and chain” that they drag with them for months and years.” (Dr. Moss)

How do we respond to this epi­dem­ic of chron­ic pain and oth­er ail­ments?  There’s one approach that’s doomed to fail…

Treat­ment based on symp­toms - This is often imprac­ti­cal and of ques­tion­able effi­ca­cy in chron­i­cal­ly ill patients.  Why?  Chron­i­cal­ly ill patients, for the most part, present with high­ly com­plex, high­ly var­ied lists of signs, symp­toms, and diag­noses that make effi­ca­cy more dif­fi­cult to attain and patient com­pli­ance a chal­lenge due to issues of prac­ti­cal­i­ty (and finances).” (Dr. Moss)

On a sim­i­lar note, treat­ment based on tra­di­tion­al med­ical def­i­n­i­tions of indi­vid­ual “dis­eases” (such as dia­betes, thy­roid defi­cien­cy, etc.) is also like­ly to be inef­fec­tive.  Chron­ic prob­lems are com­plex, mul­ti­fac­to­r­i­al, and over­whelm­ing — both for the patient and the frag­ment­ed health care sys­tem.

To his cred­it, Dr. Moss – even though he makes a liv­ing by sell­ing high qual­i­ty nutri­tion sup­ple­ments to doc­tors’ offices – also sees the lim­i­ta­tions of fan­cy nutri­tion test­ing and sup­ple­men­ta­tion pro­to­cols:

  • The process is too con­vo­lut­ed.
  • Not all of the diag­nos­tic tests  are wide­ly accept­ed with­in the med­ical world.
  • The sup­ple­ment reg­i­mens can get out of con­trol, with patients swal­low­ing scores of pills morn­ing, noon, and night.
  • It’s expen­sive, and
  • In the end, just like with any oth­er med­ical pro­ce­dure, you still have to wait and see what results you get, and then mod­i­fy your pro­gram accord­ing­ly.

Over the past year and a half, Dr. Moss has shared with his read­ers (includ­ing me) an impor­tant insight about the cat­a­stro­phe of chron­ic ill­ness.

In review­ing the research lit­er­a­ture, he was struck by the sim­i­lar­i­ties between

  • chron­ic pain (and oth­er debil­i­tat­ing con­di­tions like chron­ic fatigue, fibromyal­gia, dia­betes, steno­sis, mul­ti­ple chem­i­cal sen­si­tiv­i­ties, arthri­tis, back pain, and so forth) and
  • the prob­lems of patients hos­pi­tal­ized with severe, acute dis­eases

It turns out that there are lots of sci­en­tif­ic jour­nal arti­cles about the meta­bol­ic and phys­i­o­log­i­cal respons­es to severe, acute ill­ness.  Dr. Moss had the insight to sift through the lit­er­a­ture to dis­cov­er how these acute phase respons­es — which are ben­e­fi­cial, nat­ur­al defens­es - can morph into chron­ic pain and its sis­ter dis­or­ders.

And how nutri­tion­al and lifestyle inter­ven­tions – based on the sim­plest pos­si­ble tests com­bined with old-fash­ioned com­mon sense — can begin to make a big dif­fer­ence.

You’ll be hear­ing more about this top­ic in future arti­cles.

Mean­time, I’ve devel­oped a 10-step process of “guid­ed self-care” that any­one can use to help rebound from chron­ic ill­ness.  I’ve begun mak­ing it avail­able to my patients and will now be offer­ing it online to my e-mail sub­scribers too.

It’s not med­ical (or chi­ro­prac­tic) treat­ment.  It’s self-care.  But it’s an orga­nized, guid­ed  plan of self-care.

Find out more about Dr. Lavine’s Ten Step Pro­gram to Con­quer Chron­ic Ill­ness.  Or send me an e-mail at, or call me at 212–400-9663.


About Ronald Lavine, D.C.

Dr. Lavine has more than thirty five years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods. His website,, provides more information about his approach. Please contact him at or at 212-400-9663.
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