Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Schoenfield served as associate professor of medicine and consultant in gastroenterology on the faculty of the Mayo Clinic for seven years. He became a professor of medicine in residence at UCLA from 1972 to 1999 (now emeritus). He was the director of gastroenterology at Cedars-Sinai Medical Center in Los Angeles for 25 years, where he received the chief resident's teaching award, the president's award, and the pioneer of medicine award.
It is not unusual for a patient
with fibromyalgia to ask the doctor: "What can I do to help relieve my
symptoms? After all, I am not very interested in medications."
Some patients with fibromyalgia
make this or similar statements to their doctors because they are often younger
and many do not have underlying (additional ongoing) medical conditions
(although some do). Therefore, they are not accustomed to taking medications
Are there really ways that
patients can help themselves? Yes. Here are the big three:
Self-education. Understanding the battlefield is often half the battle.
As people with fibromyalgia develop a better understanding of their
condition, it becomes far easier to cope with and address. Furthermore, for
some, simply the realization that the condition does not threaten the body's
organs and often improves over time can greatly relieve anxiety. The anxiety
is often due to concern about the cause of the frequent pains of fibromyalgia.
I would like to offer MedicineNet.com's Fibromyalgia article as an excellent
resource for patients and their family members to become more familiar with
the basic concepts of fibromyalgia and its diagnosis and treatment options. To
further complement the consultation with the doctor, other sources of
information include the Arthritis Foundation and local hospital support
reduction. Reducing stress can help with muscle relaxation and
improve non-Rapid Eye Movement (non-REM) sleep. Inadequate sleep
of this type is felt to play
a central role in promoting the symptoms of fibromyalgia. The response to stress differs from person
to person. The reduction of stress in the treatment of fibromyalgia must be individualized for each
patient. Stress reduction might include simple stress modification at home
or work, biofeedback, relaxation tapes, psychological counseling, exercise
activities such as yoga and/or support among family members, friends, and
doctors. Sometimes, changes in environmental factors (such as noise,
temperature, and weather exposure) can exacerbate the symptoms of
fibromyalgia, and these factors need to be modified.
Exercise.Aerobic activities that exercise
the muscles can work together with
the methods above to greatly relieve the symptoms of fibromyalgia. Many
experts on fibromyalgia feel that exercise works by promoting the non-REM
sleep that is commonly deficient in patients with this illness. Low-impact
aerobic exercises, such as swimming, cycling, walking, and stationary
cross-country ski machines can be very effective. For patients who are
unfamiliar with exercising options, a physical therapist can provide an
ideal source of instruction. With any new exercise program, it is important
to understand that a mild increase in aching in the first two weeks is
expected. This increased aching is especially likely to occur when the
patient has not been exercising and the muscles are deconditioned.
Sometimes, applications of cold packs to sore muscles and tendons after
exercising can help relieve muscle inflammation and soreness.
The big three methods above may be all a patient with fibromyalgia needs in order to
regain optimal health. However, especially early on in treatment, it should also
be understood that medications are available that can work with these methods to
improve sleep, reduce pain, and relieve fatigue. Typically, these medications do
not have major side effects and they may only be needed for temporary periods.
The treatment of fibromyalgia, therefore, is often a classic blend of the efforts of
the patient and the doctor who together can address the condition.
Medically reviewed by Joseph Carcione, DO; American Board of Psychiatry and Neurology
"Initial treatment of fibromyalgia in adults"