Submitted by Dr. Chris Spooner

Fibromyalgia syndrome (FMS) is a chronic syndrome characterized by widespread pain with specific tender areas . Although the etiology of FMS is unknown, this syndrome is occasionally accompanied by rheumatoid arthritis and other autoimmune diseases1. Several effective methods have been reported for the treatment of pain in patients with FMS. In addition to the use of antidepressants and a new anti-convulsant , exercise and spa therapy have been suggested to improve the symptoms in FMS patients . However, the severity of symptoms in FMS patients varies widely, and exercise and spa therapy cannot be applied in many patients with disabilities in daily life due to their compromised physical condition. Therefore, improved methods for the treatment of such patients are necessary.

Fibromyalgia (FM) is defined as a chronic generalized pain syndrome with characteristic symptoms like unrestful sleep, fatigue, stiffness, and/or mood disturbance.

The overall prevalence of FM in the general population is 2%, with a rate of 3.4% in females and 0.5% in males. FM accounts for 20% of referrals in rheumatology practices, and 7% in general practices. , FM affects nearly all aspects of life with a great impact on work ability and productivity.

Drugs are the most often used treatment option in FM, but nonpharmacologic treatments like exercises, and psychologic interventions are equally or even more effective, especially in the long run. Infrared mainly acts as a deep heat agent predominantly absorbed in the deeper layers of the skin.

In contrast to shortwave or microwave hyperthermia, infrared hyperthermia can be applied in patients with metal implants and cardiac pacemakers too.

On one study, 46 patients with chronic pain received 4 weeks of multidisciplinary treatment; 22 of the subjects also had 15-minute daily FIR Sauna sessions during those 4 weeks. After 2 years, those in the sauna group were significantly more likely to have returned to work (77% vs 50%,) and to have improved sleep scores and trended toward greater improvement in pain behaviour scores and anger scores. The authors suggested that FIR Sauna therapy might be promising for the treatment of chronic pain.

Chronic Fatigue Syndrome:

Another paper supported the use of FIR Sauna therapy for chronic fatigue syndrome suggesting that mild warming of the whole body produces a sedative effect via the sensory nerve endings. Thermal therapy also promotes blood flow in the capillaries and relieves muscular spasm related to tonic muscle contraction and pain. This study found that physical and mental complaints decreased, and pain and depressed mood improved, suggesting that repeated thermal therapy exhibits sedative and analgesic effects.

A single far-infrared ray dry sauna at 60 C elevated core body temperature by 1.2 C and induced a 1.5-fold increase in cardiac output. In patients with CFS, lower cardiac output was associated with greater severity rating for postexertional fatigue and fever chills and with lower rating for a problem with memory and concentration. The high rate of metabolism and perspiration due to increased body temperature and increased blood flow, in addition to the relaxation effects of thermal therapy, decreased subjective symptoms, resulting in increased energy scores.

Moreover, regular and prolonged (five times a week for 7 weeks) thermal therapy might prevent the exacerbation of clinical symptoms. CFS patients frequently report symptoms of subnormal body temperature and low-grade fever. Sweat rate during a single thermal therapy was estimated to be about 100 to 500 ml, based on decreased body weight. The improvement of low-grade fever in the two cases shows that thermal therapy may have a regulating action of body temperature through sweating.

Far-infrared rays have a sleep-enhancing effect, and sleep scores have been shown to improve after far-infrared thermal therapy. Increased brain temperature is associated with a type of neuronal activation typical of sleep in the hypothalamus and basal forebrain . Central nervous system arousal is reduced by increased blood temperature in the hypothalamus; consequently, thermal therapy may have a sleep inducing effect. The improvement of mental symptoms may be produced by the reduction of persistent fatigue or pain and improvement of sleep disturbance in repeated thermal therapy.

The symptoms of CFS patients dramatically improved after repeated thermal therapy. Although further studies must be made in a larger number of CFS patients, repeated thermal therapy may be a promising method for the treatment of CFS.