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Fibromyalgia Treatment with Stem Cells

16 February 2020

Introduction
What is Fibromyalgia
Management of Fibromyalgia
Pain relief
Antidepressants
Anti-seizure drugs
Alternative Medicines for Fibromyalgia
Using Stem Cells in Fibromyalgia Management
Clinical Results: What Improvements Do Patients Receive?
Testimonial of a Patient Treated at Swiss Medica
Additional Treatment Procedures
List of References

Introduction

According to estimation, fibromyalgia affects from 2% to 8% of the population [1]. It was not recognised as a separate disease until the 1980s and was strictly classified only recently. In the mid-80s, the first study of medication for fibromyalgia was published but scientists still haven’t found a cure for this disease, and treatment is limited to symptom management. The latest developments in stem cell-based regenerative medicine have contributed significantly to the treatment of fibromyalgia.

What is Fibromyalgia

Fibromyalgia is a chronic syndrome, characterised by widespread pain associated with a complex set of symptoms, mainly fatigue, sleep disturbance, impaired cognition and depression. Learn more about fibromyalgia in this educational video by the SciShow project:

The functional changes that underlie this syndrome are not clearly understood, although the following factors are identified as contributory:

Fibromyalgia syndrome is diagnosed by excluding other neurological disorders and depression, as there are no objective diagnostic tests [4].

Common pain sites in fibromyalgia.

Figure 1. Common pain sites in fibromyalgia.

Management of Fibromyalgia

Current treatment guidance says that the first step in managing fibromyalgia is educational support for patients and a focus on non-pharmacological regimens, such as exercise and psychological therapies. Experts agree that regular physical activity should also be considered a cornerstone of treatment [5, 6].

In non-responsive patients, pharmacological therapies should be added, especially to those with sleep or mood disturbances.

Algorithm of managing patients with fibromyalgia.

Figure 2. Algorithm of managing patients with fibromyalgia [7].

The following medications are usually recommended to reduce the pain of fibromyalgia and improve sleep:

Pain relief

Over-the-counter pain relief, including paracetamol and nonsteroidal anti-inflammatory drugs, may be helpful but are not suitable in every case due to their weak impact, side effects and limited period of administration. Stronger painkillers (codeine or tramadol) are prescribed when over-the-counter drugs are not effective.

Antidepressants

Among multiple antidepressants only duloxetine, milnacipran and amitriptyline have a certain effect in treating pain, fatigue, anxiety or sleep disorders associated with fibromyalgia. They mediate levels of chemicals in the body that help control pain and boost energy.

Anti-seizure drugs

Gabapentin and pregabalin – drugs that are approved to treat seizures – prevent sensitive nerves from sending too many pain signals to the brain. They are prescribed to ease certain types of pain, including in patients with fibromyalgia. Pregabalin was the first drug approved in the USA to treat fibromyalgia, but it is not approved in the EU.

The effectiveness of certain pharmaceutical drugs in a patient with fibromyalgia raises doubt among experts. Evidence for a similar efficacy of drugs belonging to the same therapeutic class (i.e. antidepressants, anticonvulsants, NSAIDs), especially those used in the management of mental health disorders, is lacking for the treatment of fibromyalgia, or managing its symptoms (pain, sleep problems, fatigue) and is not supported by evidence [8]. Often the risks of therapy outweigh the expected benefits due to intolerable adverse effects caused by these drugs. The most common, and not so common, but serious side effects are listed in Table 1.

Table 1. Risks of medications for fibromyalgia.

Class of Medications Common Side Effects Serious Side Effects

NSAIDs

  • Gastrointestinal symptoms (nausea, diarrhoea, heartburn, etc.)
  • Fatigue
  • Itching, rashes
  • Weight gain
  • Swelling (oedema)
  • Ringing in the ears (tinnitus)
  • Flu-like symptoms
  • Sensitivity to light
  • Efficacy decreases over time
  • Gastrointestinal bleeding ulcers
  • Cardiovascular complications (strokes, heart attacks, and heart-related deaths)
  • Severe rash or hives
  • Bloody or cloudy urine
  • Blurred vision
  • Extreme fatigue
  • Jaundice
Antidepressants
  • Nausea (feeling sick)
  • Dry mouth
  • Drowsiness
  • Feeling agitated, shaky or anxious
  • Insomnia
  • Dizziness
  • Blurred vision
  • Increased appetite
  • Weight gain
  • Constipation
  • Sexual problems
  • Withdrawal effect
  • Suicidal thoughts
  • Type 2 diabetes
  • Hyponatraemia – low blood sodium levels (serious cases may result in disorientation, psychosis, confusion, seizures, coma)
  • Serotonin syndrome (an exceptionally high level of serotonin may cause serious symptoms, including seizures, irregular heartbeat – arrhythmia, unconsciousness)
Anti-seizure drugs
  • Dizziness
  • Drowsiness
  • Swelling of hands and feet (oedema)
  • Weight gain
  • Behavioural changes, including hyperactivity
  • Depression
  • Suicidal thoughts or actions

Alternative Medicines for Fibromyalgia

There are some studies indicating that approaches such as traditional Chinese medicine, homeopathy, herbs and nutritional support may help patients with fibromyalgia, along with traditional medicine and physical activity [9, 10, 11, 12].

Specialists also believe that a deficit of specific vitamins, microelements and some molecules that participate in stress and pain regulation may contribute to the development of fibromyalgia symptoms. The following supplements are usually recommended as complementary treatments for fibromyalgia:

Due to a lack of strict studies into supplements, prescriptions must be issued by a qualified specialist who can weigh up all the possible risks and benefits to the patient.

Simple remedies, such as massage and warmth can reduce muscle pain and stiffness, plus provide relaxation and rest.

Using Stem Cells in Fibromyalgia Management

The latest studies of a stem cell-based approach in patients with neurological, autoimmune and musculoskeletal disorders allow for the use of this cutting-edge treatment to manage fibromyalgia.

Inflammation contributes to the development of musculoskeletal pain and other neurological symptoms. The ability of mesenchymal stem cells (MSCs), which are present in many organs of the adult body, to modulate the immune system and therefore manage inflammation has been widely studied [13, 14].

Some researchers consider fibromyalgia to be an auto-immune disease. In this context, MSCs demonstrate a benefit in accelerating recovery from acute conditions exacerbated by central inflammation, such as stroke and relapsing multiple sclerosis [15, 16, 17, 18].

In an animal model of major depressive disorder and anxiety, MSCs modulated the central inflammatory process in the nervous system and changed abnormal behavioural patterns [19].


Contact a Medical Advisor to discover the results you can get from stem cell therapy for fibromyalgia >>>

Clinical Results: What Improvements Do Patients Receive?

The cell-based treatment programmes for fibromyalgia provide a positive impact on both central and peripheral nervous systems which result in such clinical effects as:

Testimonial of a Patient Treated at Swiss Medica

Patient: Jeanne, 40 years-of-age.

Diagnosis: fibromyalgia.

Complaints and symptoms:

Cell-based treatment procedure:

  1. Adipose (fat)-derived mesenchymal stromal cells (MSCs) were obtained from the abdominal area (standard liposuction under local anaesthesia).
  2. MSCs were separated from the fat tissue and activated.
  3. The cell product was administered, via Intravenous (IV) drip, into the patient’s body.

A patient receives stem a cell product via an IV drip.

Figure 3. A patient receives stem a cell product via an IV drip.

The following improvements were observed eight months after the treatment:

Additional Treatment Procedures

Due to the complexity of fibromyalgia syndrome, additional therapies may be required to obtain the best treatment results. For each patient, an individual therapy plan is developed based on the general health status, age, concomitant diseases and other aspects. The following procedures may support stem cell treatment in patients with fibromyalgia:

Also, Swiss Medica provides supplemental consultations with interdisciplinary specialists.

The efficacy of stem cell-based therapy may vary in patients depending on multiple factors, such as initial condition, duration of the syndrome, age, family history, living habits, general well-being, etc. It works more effectively when combined with other therapeutic methods that help activate the positive regulation of the nervous system.


Contact a Medical Advisor to learn more about the benefits you may gain from stem cell treatment >>>

by Swiss Medica team

List of References

  1. Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014 Apr 16;311(15):1547-55.
  2. Keskindag B and Karaaziz M. The association between pain and sleep in fibromyalgia. Saudi Med J. 2017 May; 38(5): 465–475.
  3. Heany J. Hypothalamic-Pituitary-Adrenal Axis. In: Gellman M.D., Turner J.R. (eds) Encyclopedia of Behavioral Medicine. 2013. Springer, New York, NY.
  4. Kia S and Choy E. Update on Treatment Guideline in Fibromyalgia Syndrome with Focus on Pharmacology. Biomedicines 2017, 8;5(2).
  5. Sommer C et al. Medikamentöse Therapie des Fibromyalgiesyndroms. Der Schmerz 2012 Jul; 26, 297–310.
  6. Fitzcharles MA et al. 2012 Canadian Guidelines for the Diagnosis and Management of Fibromyalgia Syndrome.
  7. Macfarlane GJ, Kronisch C, Dean LE et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76(2):318-328.
  8. Häuser W. Facts and myths pertaining to fibromyalgia. Dialogues Clin Neurosci. 2018 Mar; 20(1): 53–62.
  9. Mist S et al. Traditional Chinese Medicine for Fibromyalgia. Pract Pain Manag. 2010 Sep 1;10(7).
  10. Dossett ML et al. Homeopathy Use in the USA and Implications for Public Health: a review. Homeopathy. 2018 Feb; 107(1): 3–9.
  11. Armstrong DJ et al. Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clin Rheumatol. 2007 Apr;26(4):551-4.
  12. Mahjoub F et al. Are Traditional Remedies Useful in Management of Fibromyalgia and Chronic Fatigue Syndrome? A Review Study. J Evid Based Complementary Altern Med. 2017 Oct;22(4): 1011–1016.
  13. Laroni A et al. Mesenchymal stem cells for the treatment of neurological diseases: Immunoregulation beyond neuroprotection. Immunol Lett. 2015 Dec;168(2):183-90.
  14. Ren J et al. Mesenchymal Stem Cells and their Exosomes: Promising Therapeutics for Chronic Pain. Curr Stem Cell Res Ther. 2019;14(8):644-653.
  15. Cohen JA. Mesenchymal stem cell transplantation in multiple sclerosis. Journal of the neurological sciences. 2013; 333:43–49.
  16. Hess DC et al. A double-blind placebo-controlled clinical evaluation of MultiStem for the treatment of ischemic stroke. International journal of stroke: official journal of the International Stroke Society. 2014; 9:381–386.
  17. Rosado-de-Castro PH, Pimentel-Coelho PM, da Fonseca LM, de Freitas GR, Mendez-Otero R. The rise of cell therapy trials for stroke: review of published and registered studies. Stem cells and development. 2013; 22:2095–2111.
  18. Vu Q, Xie K, Eckert M, Zhao W, Cramer SC. Meta-analysis of preclinical studies of mesenchymal stromal cells for ischemic stroke. Neurology. 2014; 82:1277–1286.
  19. Gallagher D et al. Mesenchymal Stromal Cells Modulate Peripheral Stress-Induced Innate Immune Activation Indirectly Limiting the Emergence of Neuroinflammation-Driven Depressive and Anxiety-like Behaviors. Biol Psychiatry. 2019 Nov 1;86(9):712-724.

Patient's results of treatment
at Swiss Medica

Parkinson's disease
Autism
Lyme disease
Dementia
Multiple Sclerosis
Osteoarthritis
Diabetes type 2
Alzheimer
Kidney Disease

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Our primary task is to make your own cells treat your own body. We use advanced technology to activate mesenchymal stem cells derived from adipose tissue, bone marrow, etc. Donated cells can also be used. Introduced to the patient’s body, these cells help to regenerate damaged tissue. Symptoms become less obvious and/or disappear.

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