Picture this. A friend greets you with a warm hug at church, and it hurts. The seams of your jersey feel rough against your shoulders. You slept eight hours and woke up feeling as though you had played a full game of rugby. Then the blood tests and X-rays come back normal, and someone gently suggests that it may be stress.
The pain is real, even when the tests are clear
Fibromyalgia is a long-term condition of widespread pain, deep tiredness, unrefreshing sleep and a kind of mental cloudiness that people often call fibro fog. It does not show up on a scan or a standard blood panel, because the muscles and joints are not being damaged.
That is good news in one sense, and deeply frustrating in another. People with fibromyalgia are too often made to feel that the pain is imagined. It is not. The current understanding is that the problem lies largely in how the nervous system processes signals, and that is every bit as physical as a broken bone.
How the volume gets stuck on high
Pain is not measured in the body and simply reported to the brain. Signals travel from the skin, muscles and joints up the spinal cord to the brain, and the brain decides how much attention they deserve. Along the way there are volume controls that can turn a signal up or down.
Central sensitisation is the name for a central nervous system, meaning the brain and spinal cord, that has become over-responsive. It is thought to play a large part in fibromyalgia, although the full picture is still being worked out. The volume seems to be set too high and to stay there. Two things are thought to follow. Things that should hurt a little hurt a lot. And things that should not hurt at all, such as light touch, a waistband or a cool breeze, begin to register as pain.
Poor sleep, stress and illness are all linked to worse pain, which may be why a bad night so often means a bad pain day.
Pain that cannot be seen on a scan is not pain that is made up. It is thought to be pain that begins in the wiring, not the tissue.
Diagnosis and medical care come first
Fibromyalgia should be diagnosed by a doctor, often with input from a rheumatologist. Part of that process is ruling out other conditions that can look similar, such as thyroid problems, inflammatory arthritis or low vitamin levels.
Treatment usually combines several things: gentle, graded exercise, better sleep, pain education, psychological support and sometimes medication. Neurofeedback does not replace any of these. It is a complementary approach that can sit alongside them.
See your doctor promptly if you notice anything that does not fit your usual pattern:
- A joint that is hot, red or visibly swollen
- Fever, night sweats or weight loss you cannot explain
- New weakness, numbness, or loss of bladder or bowel control
- Chest pain or shortness of breath, which need emergency care
- Thoughts that life is not worth living. Please tell your doctor or someone you trust today.
Where neurofeedback may help
Neurofeedback is a non-invasive form of brain training. Small sensors on the scalp read your brain's electrical activity, and nothing is sent into the brain. When your brain moves towards a calmer and steadier pattern, you get feedback through sound or a picture on a screen. The aim is that, with repetition, the brain learns the pattern that is being rewarded.
One rhythm often used in training is SMR, short for sensorimotor rhythm. It is a brainwave linked to a still body and a quietly alert mind. Encouraging it is thought of as a way of practising physical calm with a clear head.
Research on neurofeedback for fibromyalgia is still limited and preliminary, so it cannot be called proven. The aim of training is not to make the pain disappear. It is to help the nervous system settle, which may ease how pain, poor sleep and fog are experienced. Results vary from person to person.
Neurofeedback does not remove the cause of fibromyalgia. It aims to help the nervous system practise regulating itself, and a better-regulated nervous system may turn the volume down a notch.
What training looks like
At our Krugersdorp practice every client starts with a 19-channel brain map, which takes about an hour and a half. It is a recording of how your brain is functioning at rest. Training sessions last 45 to 60 minutes and start with a short check-in on how you are feeling. Our what to expect page takes you through each step.
Because sleep and pain feed each other so strongly, you may find our article on chronic insomnia and sleep spindles useful. If your pain is centred in the pelvis, we have also written about chronic pelvic and somatic pain.
Common questions
Can neurofeedback cure fibromyalgia?
No. There is no known cure for fibromyalgia, and neurofeedback does not claim to be one. It is a complementary form of brain training that may help the nervous system regulate better. The aim is for pain to feel less overwhelming and for sleep to be better supported, but the evidence is limited, results vary and medical care remains essential.
Does neurofeedback hurt or cause a flare?
The sensors only read brain activity, and nothing is sent into the brain. Some tiredness afterwards is possible, a little as you might feel after concentrating for a while. If you are sensitive to touch, mention it to any practitioner before sensors are placed. If you notice a flare after a session, tell the practitioner and your doctor.
Should I keep taking my pain medication?
Yes. Continue all medication exactly as your doctor has prescribed. Neurofeedback works alongside medical treatment, not in place of it. If you start feeling better and want to review your medicine, speak to the doctor who prescribed it. Please never stop or reduce a dose on your own, as some medicines must be tapered carefully.
Living with pain that others cannot see takes more strength than most people realise. If you have a diagnosis and a doctor looking after you, and you would like to know whether brain training could be a helpful addition, you are welcome to get in touch with Irine.
- fibromyalgia
- central sensitization
- chronic pain
- allodynia
- relief
