Naturopathy is a system of alternative medicine which promotes the body’s own self-healing mechanism to achieve homeostasis. Naturopathic model state that person should be treated holistically, and describe a person as cooperation of body, mind, and spirit called Triad of Health. Therefore, diagnosis and treatment involve recognizing a patient’s individual physical, mental, genetic, environmental, social, and other factors. An imbalance to any one or more of these areas leads to health problems, dysfunctions, and diseases.
Naturopathy uses many of alternatives therapies and diagnostic tools to bring the body back to homeostasis. These therapies are herbalism, iridology, nutrition therapy, fasting, acupuncture, hydrotherapy, enemas, fasting, massage techniques, spinal and joint manipulations, lifestyle changes and homeopathy. Although to apply these techniques naturopath must follow specific naturopathic principles (Fleming and Gutknecht, 2010). Describing the Triad of Health concept naturopathy lists the three elements of human health that are affected by everyday challenges. These three elements are structural, chemical (nutritional), and mental, a balance between them is the foundation of one’s health. Any imbalance to any one or more of these areas leads to body dysfunctions or diseases. Naturopath in order to help the patient must identify the underlying causes of disharmony and correct them using naturopathic methods. Structural aspect is any type of activity which put stress on the musculoskeletal system etc. injuries, postural dysfunction, muscular imbalance of the body causing weakness or dysfunction which affects the body’s structural equilibrium. Proper nutrition and supplementation of the body belong to the chemical aspect of the triad of health. Without a balanced diet, the body cannot develop, regenerate or fight disease. The avoidance of toxicities is another important factor that weakens general functional immunity. The stress of everyday life can perturb the mental aspect of Triad of Health the brain-mind connection causing dysfunctions of the nervous and endocrine systems. Therefore, can disrupt equilibrium with all vital organs causing all kinds of dysfunctions and diseases (Lloyd et al, 2017).
The first naturopathic principle “First, Do No Harm (primum non nocere)”, includes that every naturopath should look for the least possible interference in the patient's health in order not to worsen his condition. The second principle is “Healing Power of Nature (vis medicatrix naturae)” which means that nature has all healing powers and ability to restore lost health and balance in living beings. “Treat the Cause (tolle causam)” is a third naturopathic principle that says that the source of the illness is more important than removing the symptoms and it is also logical because the disease appears for some reason and identifying the source can remove the symptoms. Naturopaths see the body holistically (Tolle totum) as a connection of body, mind, and spirit. If one of the components is compromised, then disharmony or disease can arise. Therefore, a holistic view of physical, emotional, structural and spiritual aspect should be used in the diagnosis and addressing all aspects of treatment (Lloyd et al, 2017).
In naturopathy, Doctor means Teacher (in latin = docere) who educate individuals on how to maintain their own health as well as self-awareness of the lifestyle choices. Teaching and advises on disease prevention and health promotion (principiis obsta: sero medicina curator) belongs also to naturopathic principles. The proactivity of the naturopaths in maintain health is more reasonable and advantageous that treating the disease itself. Prevention can include education about hygiene, diet, and lifestyle. Disease prevention and health promotion will lead to not only physical balance but also will improve emotional and spiritual aspects is the last principle called by naturopath’s total wellbeing. Total wellbeing is a state where a person is in general, optimal health with positive emotions, and thoughts. Wellness is non-separable from every individual and if is recognized by the individual, will accelerate the healing process quicker than just direct treatment of the disease alone. Appropriate naturopathic treatment must be ruled by guidelines of Naturopathic Triad of Health the patient treatment plan has to be designed to evidence-based researches linked to manual therapy, diet, breathing, exercises, and hydrotherapy (Lloyd et al, 2017).
Fibromyalgia (FMS) tend to affect all three mentioned aspects of the Triad of Health. Structural aspect is characterized by chronic widespread pain and tenderness in the joints, muscle, and soft tissues but without inflammation. People diagnosed with fibromyalgia very often have associated symptoms of fatigue, insomnia, irritable bowel syndrome, headaches, and mental factors for e.g. anxiety or depression (Jay and Barkin, 2015). Recent evidence suggests fibromyalgia may be a centrally mediated disorder of pain sensitivity, but the cause is unknown, but disruption of sleep may also be caused by emotional stress (Biundo J, 2018).
To improve structural and mental factor of Triad of Health Hawkins (2013) state that soft tissue massage and osteopathic manipulations have been used frequently to reduce symptoms in patients with FMS. The benefits of such therapies can last even up to 6 months after the treatment. Castro-Sanchez et al. (2011) also state that after 20 weeks program of myofascial release technique can effectively alleviate pain reduce anxiety.
The health of the gastrointestinal tracts is important for the nutritional aspect of the Triad of Health which can influence other elements is linked to fibromyalgia. In order to improve the nutritional factor of Triad of Health in patients with FMS, Storkos (2008, p231-233) recommends a diet rich in fresh fruits, green vegetables, whole grains, lean protein, nuts, and healthy fats. Apart that author recommend reducing caffeine and sugar intake and minimize or avoid processed food as that food may trigger mood swings, overgrowth of yeast and inflammation. The author also suggests magnesium and cayenne pepper supplementation to reduce inflammation as well as substance P, which plays an important role in the sensitization of the central nervous system. The gluten-free diet can be effective in the reduction of a nutritional component in irritable bowel syndrome and fibromyalgia (Volta, 2016). Rodrigo et al. proclaim that one year of gluten-free diet significantly reduces heartburn, bloating, diffuse abdominal pain/discomfort, bowel habit alteration, constipation, and diarrhoea associated with FMS and IBS patients. Also report a significant decrease in the VAS pain score, therefore improving a structural element of Triad of Health.
Exploring further importance of the nutritional factor of Triad of Health in patients with fibromyalgia, probiotics play a significant role. Williamson et al (2017) in their study state that certain probiotic species may help to alleviate mental and nutritional symptoms of fibromyalgia. Study shows that 6-8 weeks probiotic supplementation with Bifidobacterium infantis 35624 reduces key proinflammatory factors tumour necrosis factor α (TNF-α), interleukin 6 (IL-6), C-reactive protein and therefore decreasing symptoms of 71 % of people with fibromyalgia. Also, Faecalibacterium prausnitzii producing a special protein can significantly inhibit inflammatory marker nuclear factor κB in cells of intestinal epithelia. Anxiety can be improved by supplementation of Lactobacillus species or Bacteroides fragilis also improve intestinal wall tightness and hyperpermeability. Roman et al (2018) also state that anxiety can be reduced by course of 8 weeks supplementation of Lactobacillus casei strain Shirota in patients with fibromyalgia syndrome.
Breathing can reduce the negative effect of the structural and emotional aspect of the Triad of Health. Changes in breathing pattern can alter instantly the sympathetic-parasympathetic balance and trigger a possible mechanism of pain sensitization perception within CNS (Martinez-Lavin, 2007). Schmidt et al (2017) state that from unknown reasons slow-peace breathing is effective in alleviations of symptoms of anxiety in patients with fibromyalgia. Slow peace breathing alters in many ways functioning of the autonomic nervous system (ANS) reducing the activity of sympathetic nervous system (SNS) lowering heart rate or blood pressure. Therefore, increasing activity of parasympathetic nervous system (PSNS) and the same time reduction in symptoms of chronic pain syndromes, fear, and anxiety. However, authors state that breathing mechanism should be studied further to understand and discover underlying mechanisms. Castañoa et al (2017) also state that 8 weeks breathing training effectively reduce pain and improve quality and duration of sleep in patients with fibromyalgia.
Structural and emotional aspects of Triad of Health can be balanced by low to moderate aquatic exercises and benefit people with fibromyalgia, optimize their wellness, alleviate all symptoms without serious adverse effects (Bidonde et al, 2014). Low-moderate intensity aerobic exercises are mostly tolerated by people with FMS. Performed twice a week can reduce pain, stress, and tenderness. High-intensity and strength workouts should be undertaken with extra caution (Busch et al, 2011). Tai chi is an ancient discipline practiced in Traditional Chinese Medicine to improve the defensive and medical aspects of human wellness. This is a mind-body system integrates physical, psychosocial, spiritual, and behavioral elements to optimize health. Likewise, aerobic exercises improve mental and structural factors e.g. anxiety, depression, self-efficacy, physical performance, sleep, of patients with fibromyalgia, study shows that tai chi training it turned out to be more effective than aerobic workouts within the same trial time. Benefits of Eastern body-mind practices et yoga, tai chi, qigong they turn out to be they prove helpful in supporting the treatment of fibromyalgia, which is confirmed by other scientific studies (Wang et al, 2018)
Hydrotherapy is one of the tools of the naturopathic toolbox which includes water therapy, aquatic
therapy, pool therapy, and balneotherapy (Mooventhan and Nivethitha, 2014). Fernandes et al (2016) state that 12 weeks swimming program (3 times a week) can effectively improve pain perception and mental state in patients with FMS. However, swimming has the same p-value as walking with only one exclusion that is better tolerated by the participants. Also, Mooventhan and Nivethitha (2014) in their article published that through swimming in the cold water significantly reduce fatigue, stiffness, anxiety or depression mental and structural elements of Triad of Health. According to Matsumoto et al (2011), mental and structural causative factors of FMS can be reduced significantly in pain, depression or chronic fatigue syndrome symptoms of 31–77%, after 12 weeks of thermal sauna therapy and underwater exercises 1h a day for 3 days a week. Benefits of such treatment remained relatively stable for 6 months in all cases. Although the mechanism of the pain reduction caused by thermal therapy is unclear, and also further trails are required to investigate the safety and efficiency of thermal therapy.
Summarizing the naturopathic philosophy, principles, and theories in relation to the patient's story in relation to the Health Triad. It shows that the naturopathic individual approach to the patient has effective methods in the treatment of patients with fibromyalgia. Principles of naturopathy help in the global diagnosis of the case and in preparing an effective treatment plan for sufferers o fibromyalgia syndrome. While naturopathy methods effectively improve the health of patients using physical and breathing exercises, hydrotherapy, diet, and probiotic supplementation.
All information used in this essay has been obtained from the naturopathic books, naturopathic associations, scientific journals and websites.