continued from previous post–Fibromyalgia: From Disbelief to DocumentedOver the past 12 years, doctors have recognized fibromyalgia as a centrally sensitized pain condition. (This was written in 2013, updated 2015. Research has improved since then in terms of understanding fibromyalgia. It is now November 2018, and hopefully I will again update this article in the next few months. I ask for your patience!) Central sensitization means the brain and nervous system are hypersensitive. How they interpret pain signals is not functioning properly. Also, a part of the brain that normally regulates pain perception doesn’t work well. Sleep loss in fibro contributes to this, called impairment of descending inhibition of pain. The net effect: it’s as if the volume control for pain is stuck on high.
The new pain science heralded by Lorimer Moseley, David Butler and others in Australia has a new way to understand centrally sensitized pain. Although your body seems to feel the pain, your brain turns it off or on. Every emotion, every event in our lives can influence pain, according to the biopsychosocial model of pain. If the brain decides there is a threat, it turns up the pain volume to protect. And, it is only doing it’s job!
Then, how do you turn down the pain volume?
The purpose of treatment by Moseley in Explain Pain, is to shift your view of pain from “a marker of tissue damage or disease” to “a marker of the perceived need to protect body tissue.” In other words, to learn a new way to experience the very real pain, to gain control over your experience and reduce the threat. The new pain science has a philosophy of educating people in order to desensitize the nervous system. How can that work? How do we change our experience of pain by changing how we think, feel and behave?
Neurotransmitters are the little chemical messengers that communicate between the brain and the body, and within the brain. Our neurotransmitters are affected by our thoughts. That’s right. Like the new pain science shows in research, how we interpret events influences whether our brain processes something as beneficial or dangerous. If we think the pain is catastrophic, it gets worse. When we understand the brain is trying to protect, and we increase our perception of control or safety, it turns down the volume.
Understand pain, influence your brain
In fibro, neurotransmitters signal differently than for healthy individuals. Some of them influence mood. For example, fibro sufferers have more depression. Some of them influence energy production. Fibro sufferers have sleep disturbances. Lack of sleep decreases autophagy, or the process by which the brain clears toxic metabolic wastes. Meditation has brain benefits similar to sleep!
I used to know a psychologist in Ashland, Oregon who said he could bring about a cure in 85% of fibromyalgia or chronic fatigue patients, in four sessions. He had discovered a similar pattern in their histories: their parents treated them as “wallpaper” when they were children. He meant they were acceptable as background decoration to their parents’ lives, but they didn’t matter. Or at least their feelings didn’t matter. As a result, their parents didn’t validate theim emotionally, and they tended to be stoic. They did not speak up for either their emotional pain and physical pain. But he said that can change. Like with the apporach of the new pain science, we can find new ways to make ourselves safe, to validate ourselves and our pain, to change the story we tell ourselves and our brain of who we are.
How are all these related? What do they have to do with the known association with tender points, widespread chronic pain, fatigue and sleep disorders? Research continues.
continued in Fibromyalgia Treatments