The emphasis of Fibromyalgia and Neuromuscular Pain Center of Oregon (FNPC) is on Integrative Medicine, which means combining the traditional cutting edge treatments with non-traditional proven methods to treat chronic pain. At FNPC we emphasize Functional Medicine. This is a very new and different approach to improving the chronic pain, and the associated symptoms such as depression, insomnia, and crippling fatigue. Instead of looking at, and treating health problems as isolated diseases, it treats individuals who may have bodily symptoms, imbalances and dysfunctions using scientifically grounded principles.
Functional medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting away from the traditional disease-centered focus to a more individualized systems oriented approach, functional medicine can effectively treat the whole person rather than isolated symptoms. This philosophy blends the best of modern medical science and traditional natural medical approaches to not only treat disease, but to also restore health. This comprehensive approach produces not only cost-effective results, but also a high degree of patient satisfaction.
- Provide the highest quality, state-of–the–art medical care to chronic pain/disease patients
- Deliver medical treatment in an empathetic, caring and humane manner
- Organize the center’s systems for patient convenience
- Create a team of health care professionals dedicated to chronic pain/disease management
- Promote innovative services and products to assist patient recovery in multiple aspects of their lives
Our Approach uses the FRESH M3EDICINE© protocol. This is a systematic methodology of assessing and treating complex conditions utilizing a fully integrative, multi-disciplinary approach that draws from several areas of medicine.
The benefit to patients for utilizing integrative therapies is twofold: Complementary and alternative therapy has been shown to be more cost effective than standard allopathic medicine, and tends to have better outcomes overall. In a review of 14 studies looking at these two factors, Herman, Craig, and Caspi (2005), found that most of the patients receiving some form of CAM care had better health effects compared with usual standard of care and all the studies showed better or at least similar effects.
The FRESH M3EDICINE© acronym stands for: Food, Rehabilitation, Endocrine, Sleep, Hormones, Medications, Musculo-skeletal, Mitochondria/Methylation, Exercise, Detoxification, Inflammation, Counseling and Cognitive Behavioral Interventions, Immune/Infection, Nutrients, Environmental Stressors.
Food: Diet is the cornerstone of many therapies. We have developed dietary nutrition protocols which can help address multiple aspects of the system. This helps with inflammation, metabolic parameters (cholesterol, blood sugar), helps you lose weight, and improve your overall energy and health.
Rehabilitation: Pain is a signal for dysfunction. Through structured physical and occupational therapy, we can help improve mobility and function.
Endocrine: optimizing metabolism can improve your overall sense of well-being. We target insulin resistance and inflammation and specifically look for optimal thyroid function.
Sleep: is another cornerstone of health. Without proper rest the body cannot heal. We address sleep dysfunction through several methods, including evaluation of the adrenal glands, cortisol-insulin balance and circadian rhythm patterns, as well as through the treatment of anxiety and trauma. We can also refer for sleep apnea evaluations.
Hormones: Many factors can influence male and female hormone patterns and their effect on health. We look for patterns and clinically correctable areas to target and bring your body back into balance. We can work closely with your endocrinologist.
Medications: Our focus is on optimization with an emphasis on non-narcotic pain management. One of the key principles of pain management is to identify the appropriate medications for the individual. We look at dosing, timing, and combinations. We attempt to limit the burden of a poly-pharmacological approach.
· Why non-narcotic management? Studies have proven that the dangerous risks of addiction and abuse vastly outweigh any benefit of narcotic pain treatment.
In addition, many of the conditions we treat do not respond well to narcotics, or even make them worse on a biochemical level.
· Dangers of poly-pharmacy. Here is another very interesting clip about polypharmacy (the first minute applies to our topic, the rest of the video touches on other topics.) http://www.youtube.com/watch?v=OAE9bUtHJE4
Musculo-Skeletal: Often the body can develop chronic structural issues from injury, degenerative changes and neurological imbalance, and even stress. We use innovative techniques drawn from several disciplines to relieve pain and improve function. Examples include: Muscle injections, Chiropractic, Acupuncture, neural and prolotherapy, and bee venom therapy.
Mitochondria/Methylation: Methylation is a process that happens in every cell of our body. Many chronic conditions including fibromyalgia, migraines and chronic fatigue have an associated dysfunction of the mitochondria which are the “power plants” of our cells. By improving mitochondrial function, we can improve all aspects of the system.
Here are some of the ways we use methylation: Cell division and renewal; Healthy immune cells; Synthesizing and clearing adrenaline; Detoxification in the liver (and elsewhere); Producing energy for cells to use in chemical reactions; Clearing out excess estrogens and histamine; Regulating how our genes get expressed
· You may have heard about the MTHFR gene. MTHFR stands for methylenetetrahydrofolate reductase, an enzyme that converts folate into the active form (5-mTHF) that can be used to make S-adenosylmethionine (SAMe). SAMe is a fantastically versatile compound and used in most methylation reactions. A well-functioning MTHFR gene also helps to keep homocysteine within normal levels. Homocysteine is a compound that may have come onto your radar if you have heart disease since higher levels have been associated with worse outcomes if you have this condition.
· If you already know what MTHFR is, perhaps you know that you have a variant of this gene such as C677T or A1298C. If you have two copies of the C677T gene (this means you are homozygous for this variant) then the MTHFR enzyme’s activity can drop by 70-75%. If you have one copy of this gene (heterozygote) then activity can be reduced by 33-35%. If you have two copies of the A1298C variant you may lose 39% of MTHFR activity. For more information, visit www.MTHFR.net.
Exercise: “motion is lotion”. Our bodies are designed to move. We recommend specific exercise and reeducation techniques for long term maintenance.
Detoxification: We advocate gentle detoxification of the body for all our patients through diet, digestive support and depurative techniques. We strive to support the body’s ability to eliminate chemical and toxins to reduce long term negative effects. In certain cases, more advanced techniques may be required.
· Calculate the Mercury content in your fish: https://seaturtles.org/programs/mercury/
Inflammation: Most, if not all, pain and autoimmune conditions are associated with inflammation of various forms. Addressing chronic underlying inflammation is a hallmark feature of our program. We accomplish this through diet, microbiome balancing and repair of intestinal permeability, as well as eliminating “triggers” and replacing nutrients.
Counseling/Cognitive Behavioral: We believe that counseling and mind-body medicine is a key feature in addressing all chronic pain. We employ several techniques including heart rate variability, relaxation training, and cognitive reframing. We believe that the way we think about and perceive the world around us and situations that arise, such as chronic pain, significantly effects our emotions and behaviors. Thinking in a more productive, proactive, and positive way will help all parts of functioning, including pain.
Immune and Infection: Many factors burden our immune system including decreased tolerance to normal foods, “bad” GI bacteria, called dysbiosis, autoimmune issues and chronic underlying infections. By treating infections and strengthening the immune system we can help improve overall health.
Nutrients: Many conditions are associated with nutritional deficiencies, and many commonly prescribed medications deplete nutrients. Common deficiencies include Vitamin D, B6, B12 and Magnesium. In some cases genetic mutations in the MTHFR pathway can cause further issues. We test and target specific nutrient deficiencies through a process called metabolic correction.
Environmental Stressors: It is our goal to help patients address factors in both their environment and life.
The protocol is by its nature dynamic and not necessarily performed in a specific order. Additionally, not every patient may need every aspect, and therefore individualized to the person and condition. The objective is to achieve cumulative and additive effects with these combinations of interventions. Typical clinical tools include pain medication optimization, interventional injections, dietary therapy, metabolic correction with nutrients, acupuncture and physical medicine techniques, herbal therapies, mind-body techniques, and detoxification strategies.
Emphasis is placed on underlying correction of systems-level dysfunctions by applying Functional and Naturopathic therapies within the current Western medical framework.
First Do No Harm – Utilize the most natural, least invasive and least toxic therapies.
Doctor as Teacher – Educate patients in the steps to achieving and maintaining health.
Prevention – Focus on overall health, wellness and disease prevention.
Treat the Whole Person – View the body as an integrated whole in all its physical and spiritual dimensions.
Identify and Treat the Causes – Look beyond the symptoms to the underlying cause.