Fibromyalgia and the Mind-Body-Spirit Connection with William B. Salt II

By William B. Salt II
WebMD Live Events Transcript

Join our discussion with authors William B. Salt II, MD, and Edwin H. Season, MD, about treating the pain and fatigue associated with fibromyalgia and the role the mind/body/spirit connection plays in the condition.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome to WebMD Live. Today we will be discussing Fribromyalgia with William B. Salt, II, M.D., and Edwin H. Season, M.D.

William B. Salt II, M.D., is board-certified in both internal medicine and gastroenterology. He received his M.D. degree from The Ohio State University in Columbus, Ohio, in 1972, where he currently holds an appointment as Clinical Associate Professor in Medicine. He trained for five more years in internal medicine and gastroenterology at Vanderbilt University Hospitals in Nashville, Tennessee, where he also served as a Chief Resident in Medicine.

Edwin H. Season, M.D., is board-certified in orthopedic surgery. He received his M.D. degree from The Ohio State University in Columbus, Ohio, in 1971, followed by internship at the University of Virginia. He then returned to Ohio State for his residency and upon its completion, taught orthopedic surgery as an assistant professor in The Ohio State University College of Medicine from 1976 to 1980.

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Dr. Salt, Dr. Season, welcome back to WebMD Live.

What is fibromyalgia?

Dr. Season: Fibromyalgia is wide-spread muscular aching pain and stiffness, associated with tenderness on palpation of characteristic paired sights called trigger, or tender points located in the neck, the back, and the extremities. Fibromyalgia, in addition to having widespread muscular pain, also has fatigue, a sleeping disorder, and some type of stress-anxiety and depression.

Moderator: What causes it?

Dr. Salt: Fibromyalgia is considered to be a functional illness, so the symptoms are real and not imagined, and the medical tests are normal. Most patients and doctors view and understand fibromyalgia and related functional illnesses through what we call a bio-medical model, that fails to explain illness where there is no evidence of disease. The model is based upon "reductionism," where all problems can be explained A to B, cause and effect, and based upon dualism, that the mind and body are split and separate. But the reality is, all illness is multi-dimensional. In other words, fibromyalgia and other functional illnesses can really be understood through what doctors call a biopsychosocial-spiritual model. Dr. Season and I propose that people, patients and doctors, need to use a common language to understand the cause of fibromyalgia, and how to feel better with it. It's important then to understand that the functional illnesses like fibromyalgia are best addressed by recognizing, understanding, and accepting the connection of body, mind and spirit, the inter-relationships of body, mind, and spirit with genetics, environment, and society, and the impact and influence of conscious as well as unconscious mind, though, and motion and stress.

Moderator: Are the symptoms all in the head?

Dr. Salt: The symptoms are not all in the head, but they are in the mind-body-spirit. The organ in the head, the brain and the mind, is connected to the body, and we know this through the spinal cord connection, through the autonomic nervous system, and through the neuropeptide messenger communication system, that is, small protein molecules that circulate through the body and communicate messages back and forth between brain and body and vice versa. So we know that we have to look at the mind-body, and really the spirit, from a holistic perspective to begin to understand that the symptoms, though real, cannot be explained through a bio-medical model which looks at body only.

We believe there's a relationship between fibromyalgia and an abnormal reaction to stress, or an abnormal stress response. Stress can be defined as the perception of a physical or psychological threat, and the perception of being ill-prepared to cope with that threat. Anytime an individual is undergoing excessive stress, that can be a contributing factor to fibromyalgia. Remember 2 things about stress -- the first is that stress is perceptual. One person's poison is another person's potion. Second, the perception of stress may be occurring at an unconscious mind level, so we may be unaware that we're under the stress from a cognitive perspective.

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