Fibromyalgia, Inflammation and Fear

There’s this lesson I learned early in PT school about how to best support a patient with fibromyalgia. At the time, research strongly suggested that progressive exercise instruction was the most effective treatment strategy, and that manual therapy interventions were unlikely to show significant progress in patient symptoms. As I’ve gained experience over the years, I’ve begun to see the deeper process at play with these individuals. It has less to do with the type of intervention, and more to do with balancing the emotional and inflammatory factors at play.

Contrary to the research, exercise is not always the most appropriate intervention for fibromyalgia. I’ve had patients experience a sympathetic response just from taking them through basic core activation exercises. The reason? Such exercises require the patient to really “tune into” their body. If someone has unresolved trauma, listening to the sensations of the body can be incredibly triggering.

This can also happen with body work. Tight muscles might be holding on to more than we realize, and forceful release of such muscles can cause our nervous system to panic. Our bodies communicate with us through emotions and sensations. If someone is not feeling safe in their body, then no intervention will help them without first addressing this basic need.

Nervous system regulation is a powerful tool in addressing the fear-based components of chronic pain, but it’s only one piece of the puzzle. Inflammation plays a major role, especially when combined with emotional charge. If our nervous system is battling a chronic, low grade viral infection (i.e. Epstein Barr, Herpes, etc.) then nervous system regulation will already be a challenge. Add any layer of trauma, fear or emotional holding on top of that, and you have the perfect storm for fibromyalgia, body pain, and any other pain syndrome poorly understood by modern medicine.

The benefit of an energetic assessment is that each physical, emotional, and spiritual layer can be evaluated and prioritized as needed. When I’m working on a patient, the body will show me which layers need to be addressed first. For individuals with chronic pain, sometimes I will “see” the physical body as the primary system needing support. This can look like specific regions of inflammation in joints, nerves or organs. Other times the physical body doesn’t come into my awareness at all, and instead I’m shown the emotional layers that need support first. And other times, a region of chronic pain may be related to ancestral or past life trauma, which rarely gets addressed with conventional practitioners.

There are many paths to accomplishing the emotional and physical healing required for relief from chronic pain. Each person suffering from chronic pain is unique in their underlying causes, and deserves to be evaluated accordingly. If exercise-training or manual therapy interventions don’t seem to be moving the dial on your symptoms, know that there are other modalities out there that can shed light on the deeper processes at play.