Additional supplementation strategies which are recommended after clinical study include use of vitamin B3 and B6 which together with magnesium and tryptophan (obtainable from a good protein meal) are needed to manufacture serotonin.

The amino acids ornithine and arginine can be used to promote Growth hormone production. Calcium and zinc supplementation is commonly found to help sleep patterns return to normal.

General nutritional status support can usefully include supplementation with B-complex and vitamin C as well as essential fatty acids derived from flaxseeds or evening primrose.

Dr.Travell 17 has confirmed that a variety of factors can all help to maintain and enhance trigger point activity: nutritional deficiency especially vitamins C, B-complex and iron; hormonal imbalances (low thyroid hormone production, menopausal or premenstrual situations); infections (bacteria, viruses or yeast); allergies (wheat and dairy in particular); low oxygenation of tissues (aggravated by tension, stress, inactivity, poor respiration).

Vibrational Therapy (Massage/Percussion Analgesia)
Rapid low level vibration has been shown to provide a speedy, safe and effective method for easing pain. A hand held vibrator is suitable for this purpose and may require firm pressure contact of the vibrator for up to half an hour before relief is strongly noticed. Vibration (100 to 200 cycles per second) should continue for 45 minutes at least. Relief of even chronic pain can last for many hours and in some instances for days. A high frequency works best (100Hz) if applied near to or below the area of pain (or according to Richard van Why to an antagonistic muscle or directly to a trigger point or reference zone).¹⁸

Manually applied vibration or rhythmic rocking (‘Harmonic Technique’¹⁹) is extremely soothing and helpful in chronic pain conditions with a tradition going back to the American Civil War where the method was used to help the pain of amputees.

Research at the University of California, Irvine, has show that when a range of physical methods were tested in treatment of myofascial pain including placebo ultrasound, spray and stretch, hydrocollator, real ultrasound and massage (ischemic compression/NMT) it was massage which came out ahead in providing immediate relief.²⁰

References
1. McCain G Role of physical fitness training in fibrositis/fibromyalgia syndrome American Journal of Medicine 1986 (supplement 3A)pp73-77

2. Dr.P.Baldry Acupuncture, Trigger Points and Musculoskeletal Pain (Churchill Livingstone, Edinburgh, 1993

3. DeLuze C et al Electroacupuncture in fibromyalgia British Medical Journal 21 October 1992 pp1249-1252

4. Sandford Kiser R et al Acupuncture relief of chronic pain syndrome correlates with increased plasma metenkephalin concentrations Lancet 1983;ii:1394-1396

5. Beck A et al Cognitive therapy in depression Guildford press New York 1979

6. Deale A Wessley S Cognitive-behavioural approach to CFS The Therapist 2(1)1994 pp11-14

7. Kacera W Fibromyalgia and chronic fatigue - a different strain of the same disease? Canadian Journal of Herbalism October 1993 Vol.XlV no lV pp20-29

8. Fisher P et al Effect of homoeopathic treatment of fibrositis (primary fibromyalgia) British Medical Journal 32pp365-366 1989