Homeopathy in Fibromyalgia

Author: European Central Council of Homeopaths

Homeopathy effective in fibromyalgia

Homeopathy is effective in treating patients suffering from fibromyalgia. Fibromyalgia is a widely misunderstood condition which can greatly reduce patients’ quality of life. No curative conventional treatment exists, but homeopaths have considerable positive experience in treating fibromyalgia patients that is supported by clinical research evidence.

Research – clear evidence of improvement from homeopathy

In a newly published trial of 47 patients diagnosed with fibromayalgia researchers found significant improvement in those patients treated with homeopathy (Relton et al. 2009). Patients were either treated by conventional care alone, or by homeopathic treatment in addition to conventional care. Significant improvement was seen in function, pain, fatigue and tiredness in the homeopathy group. No side-effects of homeopathic treatment were noted.

Significant effect in placebo-controlled trials

An important question to answer is whether the effect of homeopathic treatment is a result of the so-called placebo effect (the effect of the patient’s belief that they will improve), or whether there is an identifiable effect of the prescribed homeopathic medicines. High quality research indicates that homeopathic medicines do have an effect. In a study of over 50 patients who received either individually prescribed homeopathic medicines or placebo (dummy) pills, clear effect was seen in the group taking homeopathic medicines (Bell et al. 2004 a). Neither patients nor practitioners knew who had received what, until after the conclusion of the trial. Significant improvement was seen both in the number of painful points and in the degree of pain. Homeopathy patients also experienced improvement in quality of life, general state of health and mood. The trial was carried out over a period of 4 months. An independent external assessor not otherwise involved in the trial, evaluated patients’ response to treatment.

An earlier placebo controlled trial of 30 patients also showed reduction in the number of tender points, pain and improved sleep in patients receiving a homeopathic medicine, compared to those who received placebo.

EEG measurement shows effect of homeopathy

Significant differences were also found when measuring fibromyalgia patients’ brain wave patterns using electroencephalography (EEG) (Bell et al. 2004 b, c). Significant differences were found between patients receiving homeopathic medicine and those receiving placebo. Moreover, patterns improved significantly in homeopathy patients after 3 and 6 months.

The way forward for fibromyalgia patients

Many patients diagnosed with fibromyalgia experience frustration as they are not always taken seriously by some healthcare professionals. Although this is not a terminal illness, it often affects patients’ quality of life considerably. The public, patients and healthcare professionals need to learn more about fibromyalgia.

Research confirms homeopaths’ positive experience in clinical practice. More research should be carried out to further test the effect of homeopathy in patients diagnosed with fibromyalgia. Some researchers have suggested that CAM therapies such as homeopathy could be recommended within a multi-component therapy setting (Langhorst et al. 2008). Homeopaths and other healthcare professionals working together could greatly help improve the health of these patients.

 

References – homeopathy trials

Bell IR, Lewis DA, Brooks AJ, Schwartz GE, Lewis SE, Walsh BT, Baldwin CM. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology, 2004 a. Doi: 10.1093/rheumatology/keh111

Bell IR, Lewis DA, Lewis SE, Schwartz GE, Brooks AJ, Scott A, Baldwin CM. EEG Alpha sensitization in individualized homeopathic treatment of fibromyalgia. Intern J Neuroscience, 2004 b, 114, 1195-1220.

Bell IR, Lewis DA, Schwartz GE, Lewis SE, Capsi O, Scott A, Brooks AJ, Baldwin CM. Electroencephalographic cordance patterns distinguish exceptional clinical responders with fibromyalgia to individualized homeopathic medicines. The Journal of Alternative and Complementary Medicine, 2004 c, 10(2), 285-299.

Fisher P, Greenwood A, Huskisson EC et al. Effect of homoeopathic treatment on fibrositis (primary fibromyalgia). British Medical Journal 1989; 299: 365–366

Relton C, Smith C, Raw J, Walters C, Adebajo AO, Thomas KJ, Young TA. Healthcare provided by a homeopath as an adjunct to usual care for fibromyalgia (FMS): results of a pilot randomised controlled trial. Homeopathy, 2009, 98, 77-82.

References – other

Holdcraft LC, Assefi N, Buchwald D. Complementary and alternative medicine in fibromyalgia and related symptoms. Best Practice & Research Clinical Rheumatology, 2003, 17(4), 667-683.

Hudson JI, Pope Jr. HG. The relationship between Fibromyalgia and major depressive disorder. Rheum Dis Clin North Am 1996; 22: 285–303.

Langhorst J, Häuser W, Irnich D, Speeck N, Felde E, Winkelmann A, Lucius H, Michalsen A, Musial F. Komplementäre und alternative Verfahren beim Fibromyalgiesyndrom. [Alternative and complementary therapies in fibromyalgia syndrome] Schmerz, 2008, 22(3), 324-33.

Lawrence RC, Helmick CG, Arnett FC et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum, 1998, 41, 778–99.

Other sources

Mayo Clinic http://www.mayoclinic.com/health/fibromyalgia/AR00056

National Institute for Health http://www.nlm.nih.gov/medlineplus/fibromyalgia.html

National Institute of Arthritis and Musculoskeletal and Skin Diseases

Additional information for homeopaths

The following information is not necessarily important to present to the public/media. It has however been added to provide homeopaths with more information, in case any further details are requested by journalists or by the public. Additional questions may be directed to ECCH by e-mailing homeopat@email.com

Bell et al. 2004

Objective: To assess the efficacy of individualised homeopathy in treatment of patients diagnosed with fibromyalgia.

Methods: Double-blind, randomized, parallel-group, placebo-controlled trial of homeopathy.

A diagnosed of fibromyalgia had been confirmed by a physician.

Recruited: 62 patients. Completed: 53 patients.

Reasons for not participating in the trial included reluctance to travel, unwillingness to complete extensive questionnaires and laboratory components of the study.

Patients’ mean age: 49 years (S.D.10). 94 % women.

Homeopathic prescriptions were made jointly by 2 experienced homeopaths.

Follow-up consultations were carried out at baseline, 2, 4 and 6 months.

41 different remedies were prescribed across the patients.

Homeopathic remedies were prescribed daily in LM potencies, starting with LM1.

LM potencies were used to:

–       Overcome antidoting effects of conventional drugs patients might be on

(Patients could however not have a history of alcohol or drug abuse, currently take narcotic analgesic, benzodiazepine or antihypertensive medication use)

–       Reduce risk of aggravation of patients’ symptoms

Average number of remedies prescribed were significantly higher in the placebo group (mean 1.7, S.D. 0.7), than the active treatment group (mean 1.3, S.D. 0.5) (P = 0.023).

A significantly higher proportion of patients in the active group experienced at least a 25 % improvement in tender point pain on examination (50 %) versus placebo (15 %) (P = 0.008).

At the 4-month homeopathic visit, patients on active treatment rated the helpfulness of the treatment (7.8 S.E. 0.06) significantly greater than those on placebo (5.3, S.E. 0.5) (P = 0.004).

Self-rating scales were used for: quality of life, pain, mood, global health at baseline + 3 months.

Results: Patients receiving active homeopathic treatment showed significantly greater improvements in tender point count and pain, quality of life, global health, + a trend toward less depression, compared with placebo.

Tender point count and pain examined by medical assessor uninvolved in providing care.

Patients were evaluated by a rheumatologist or physician’s assistant.

Electroencephalography (EEG) and electrocardiography were used to test response to double-blind olfactory-administered test doses of their treatment (Bell et al. 2004 b, c).

Weakness of the study: Small group sample.

Fisher et al. 1989

All patients were treated with either Rhus toxicodendron C6 or placebo.

Tender points were reduced in the homeopathy group by 25 %.

Pain and sleep recorded on visual analogue scales (VAS) improved compared to placebo.

Weakness of the study:

–       Not individualised treatment

–       Small group sample. Short trial period.

–       Sleep and pain scores were not reported separately.

–       There was no wash-out period between active and placebo interventions.

Relton et al. 2009

Objectives: To assess the feasibility of a Randomised Controlled Trial (RCT) design for usual care compared with usual care plus adjunctive care by a homeopath for patients with Fibromyalgia syndrome (FMS).

Method: Pragmatic parallel group RCT design.

Patients were adults with a diagnosis of FMS.

Patients excluded: Pain from traumatic injury or structural disease, rheumatoid arthritis, inflammatory arthritis, autoimmune diseases, immunosuppressant treatment, oral steroid treatment, acupuncture treatment, homeopathic treatment, substance abuse, primary psychiatric diagnosis or illness, chronic sedative use, pregnancy or lactation.

Patients were randomly allocated to usual care or usual care + adjunctive homeopathy care.

Usual care group received one or more of the following:

–       physiotherapy

–       aerobic exercise

–       analgesics

–       non-steroidal anti-inflammatory drugs (NSAIDs)

–       anti depressants

Homeopathy care involved in depth interviews and individualised homeopathic medicines.

Patients received usual care plus:

–       Initial 60 minute interview

–       2 x 30 minute follow up interviews (4-6 weeks apart)

–       Individually tailored homeopathic medicines

Interviews were carried out by two homeopaths who jointly agreed on each remedy selection.

Non-patient reported outcome Tender Point Count was conducted by an independent assessor (research nurse) who was masked to group allocation.

Primary outcome measure: Difference in Fibromyalgia Impact Questionnaire (FIQ) at 22 weeks.

Results: 47 patients recruited. Drop out rate higher in usual care compared to homeopathy care (8/24 vs 3/23). Significant reduction in FIQ score (function) in the homeopathy group compared to the usual care group (-7.62 vs 3.63). Significantly greater reduction in homeopathy group in McGill pain score, FIQ fatigue and tiredness upon waking scores. Small effect on pain score (0.21, 95% CI –1.42 to 1.84), large effect on function (0.81, 95% CI –8.17 to 9.79).

No reported serious side effects.

The drop out rate was low in the homeopathy group (3/23), indicating that the intervention was experienced as beneficial. The usual care group had a higher drop out rate (8/24).

Weakness of the study:

–       Small group sample

–       High drop out rate in usual care group

Note: This study does not test whether homeopathic medicines work better than placebo.