Fibromyalgia

Overview

Fibromyalgia is a complex chronic pain disorder characterised by widespread musculoskeletal pain, fatigue, sleep disturbances, cognitive difficulties, and heightened sensitivity to physical stimuli. Affecting approximately 2-4% of the population, with a significantly higher prevalence in women, fibromyalgia presents a constellation of symptoms that profoundly impact quality of life, daily functioning, relationships, and emotional well-being. The condition involves altered pain processing in the central nervous system, with individuals experiencing amplified pain signals and reduced pain thresholds—a phenomenon called central sensitisation. Unlike inflammatory arthritis or tissue damage, fibromyalgia doesn't cause visible joint swelling or structural damage, which historically led to dismissal or misunderstanding of patients' experiences. Diagnosis relies on clinical criteria, including widespread pain lasting at least three months and the presence of other characteristic symptoms, as no definitive laboratory test or imaging study can confirm the condition.

While conventional treatments include pain medications, antidepressants, and anti-seizure drugs that modulate pain pathways, many individuals find incomplete relief and experience significant medication side effects. Traditional, Complementary, and Integrative Health (TCIH) modalities offer valuable approaches that address the multidimensional nature of fibromyalgia through gentle, body-centred therapies that reduce pain, improve function, support restorative sleep, calm the nervous system, and restore quality of life without the side effects common to pharmaceutical interventions.

Common Causes and Contributing Factors

• Central sensitisation - Altered pain processing in the brain and spinal cord, where the nervous system becomes hyperresponsive to stimuli, amplifying pain signals
• Genetic predisposition - Family history of fibromyalgia, chronic pain conditions, or mood disorders suggesting hereditary susceptibility through multiple genetic variations
• Triggering events - Physical trauma, infections (particularly viral illnesses), surgery, significant emotional stress, or PTSD often precede fibromyalgia onset
• Sleep disturbances - Non-restorative sleep, reduced deep sleep stages, and sleep disorders both contribute to and result from fibromyalgia, creating a vicious cycle
• Stress and emotional factors - Chronic stress, anxiety, depression, and trauma affect pain perception, muscle tension, inflammation, and symptom severity
• Neurotransmitter imbalances - Abnormal levels of substance P (elevated), serotonin (reduced), and dopamine affecting pain modulation and mood regulation
• Mitochondrial dysfunction - Impaired cellular energy production may contribute to fatigue, pain, and exercise intolerance common in fibromyalgia
• Immune system dysregulation - Inflammatory cytokines and immune abnormalities may play a role in symptom generation and maintenance
• Hormonal factors - Thyroid dysfunction, sex hormone imbalances, and hypothalamic-pituitary-adrenal (HPA) axis dysregulation affect symptoms
• Lifestyle factors - Sedentary behaviour, poor nutrition, inadequate stress management, and social isolation exacerbate symptoms and reduce coping capacity

Signs and Symptoms

• Widespread chronic pain - Persistent pain affecting both sides of the body, above and below the waist, often described as deep, aching, burning, or stabbing
• Severe fatigue - Profound exhaustion unrelieved by rest, limiting daily activities and often accompanied by post-exertional malaise
• Sleep problems - Non-restorative sleep, difficulty falling or staying asleep, frequent waking, or waking feeling unrefreshed despite adequate sleep duration
• Cognitive difficulties - "Fibro fog", including problems with memory, concentration, attention, word-finding, and mental clarity, affecting work and daily tasks
• Tender points - Specific anatomical sites that are particularly painful when pressure is applied, though newer diagnostic criteria focus on the widespread pain index
• Stiffness - Morning stiffness and generalised muscle rigidity, particularly after periods of inactivity or upon waking
• Headaches - Frequent tension-type headaches or migraines often accompany fibromyalgia
• Heightened sensitivities - Increased sensitivity to pain, touch, light, sound, odours, temperature changes, and sometimes foods or chemicals
• Mood disturbances - Depression, anxiety, irritability, or mood swings related to chronic pain, sleep deprivation, and neurochemical imbalances
• Additional symptoms - Irritable bowel syndrome, temporomandibular joint disorder, restless legs syndrome, numbness or tingling, and other overlapping conditions

Holistic and TCIH Approaches

Holistic and Traditional, Complementary and Integrative Healthcare (TCIH) care addresses the complex, multisystem nature of fibromyalgia through gentle, non-invasive approaches that calm the nervous system, reduce pain, restore function, improve sleep, and enhance overall well-being without exacerbating symptoms.

• Acupuncture offers significant benefits for fibromyalgia through its pain-modulating effects and nervous system regulation. Fine needles inserted at specific points stimulate the release of endorphins and other natural pain-relieving chemicals, regulate neurotransmitters including serotonin and substance P involved in pain processing, reduce muscle tension and trigger points, improve sleep quality and depth, and calm the hyperactive stress response. Research demonstrates that acupuncture can significantly reduce pain intensity and tender point count in fibromyalgia patients, improve quality of life, and provide sustained benefits with regular treatment. Sessions are typically gentle and relaxing, scheduled weekly initially and adjusted based on response, providing a safe complement to conventional therapies^[3].
• Myofascial Release Therapy employs gentle, sustained pressure on the fascia—the connective tissue network surrounding muscles, bones, and organs—to release restrictions, reduce pain, and restore mobility. In fibromyalgia, fascial restrictions and trigger points contribute significantly to pain and dysfunction. This hands-on approach involves slow, deliberate stretching and compression of fascial tissues, identifying and releasing areas of restriction and adhesion, improving tissue hydration and circulation, reducing muscle guarding and tension patterns, and restoring more normal movement patterns. Unlike deep tissue massage, which can exacerbate fibromyalgia symptoms, myofascial release is gentle and gradually progressive, working with the body's natural rhythms and respecting individual pain tolerance^[8].
• Yin Yoga and Hatha Yoga provide accessible movement practices specifically appropriate for fibromyalgia's sensitivity to exertion. Yin yoga involves long-held, passive poses targeting deep connective tissues, promoting relaxation and gentle stretching without muscular effort; Hatha yoga offers slow-paced, mindful postures with modifications for individual limitations, building strength and flexibility gradually. These practices improve flexibility and range of motion without overwhelming the system, reduce pain and stiffness through gentle movement, calm the nervous system through breath awareness and meditation, improve sleep quality through relaxation and stress reduction, and provide a sense of accomplishment and body connection. Classes specifically designed for chronic pain or fibromyalgia, or individual instruction, ensure appropriate pacing and modifications^[9].
• Craniosacral Therapy uses extremely gentle touch to release restrictions in the craniosacral system—the membranes and cerebrospinal fluid surrounding the brain and spinal cord. This subtle approach is particularly well-suited to fibromyalgia's pain sensitivity, involving light pressure (about the weight of a nickel) to assess and facilitate releases in the cranial bones, spine, and sacrum. Benefits include profound nervous system calming and parasympathetic activation, release of fascial restrictions affecting the central nervous system, improved cerebrospinal fluid circulation, potentially affecting pain processing, deep relaxation often resulting in improved sleep, and gentle support for the body's self-healing mechanisms. Sessions are deeply relaxing and non-invasive, making this approach accessible even during symptom flares^[10].
• Bowen Therapy consists of gentle, rolling movements over muscles, tendons, and fascia at specific points on the body, followed by pauses allowing the body to respond and integrate. This Australian bodywork technique is remarkably gentle yet effective for fibromyalgia, stimulating the body's natural healing response through the autonomic nervous system, reducing muscle tension and pain through fascial release, improving lymphatic drainage and circulation, promoting deep relaxation and parasympathetic dominance, and often providing cumulative benefits over a series of sessions. The distinctive pauses between moves allow the nervous system to process and respond, making it particularly suitable for the sensitive, hyperresponsive nervous system characteristic of fibromyalgia^[10].
• Hydrotherapy (Balneotherapy) involves the therapeutic use of water at various temperatures for pain relief and healing. Balneotherapy specifically refers to bathing in mineral-rich or thermal waters with therapeutic properties. For fibromyalgia, warm water immersion provides buoyancy, reducing joint and muscle stress, warmth promoting muscle relaxation and pain relief, hydrostatic pressure improving circulation and reducing swelling, and a soothing environment for gentle exercise and movement. Activities may include warm pool exercise or aquatic therapy, soaking in warm baths with Epsom salts (magnesium sulfate) for muscle relaxation, alternating temperatures (carefully) to stimulate circulation, and spa treatments in therapeutic mineral springs. Water-based activities allow movement and exercise with minimal pain and are often better tolerated than land-based activities^[7].
• Mindfulness encompasses meditation and present-moment awareness practices that fundamentally change the relationship to pain and suffering. Research demonstrates significant benefits for fibromyalgia, including reduced pain intensity and interference with daily activities, improved pain catastrophizing and emotional responses to pain, enhanced sleep quality and duration, reduced depression and anxiety, improved overall quality of life and functional capacity, and sustainable benefits maintained with continued practice. Mindfulness-based stress reduction (MBSR) and similar programs teach body scan meditation to develop awareness without judgment, sitting meditation to observe thoughts and sensations, mindful movement integrating gentle yoga, and integration of mindfulness into daily activities. This approach helps individuals respond rather than react to pain and stress, reducing suffering even when pain persists^[1,2,4].

Self-Care and Lifestyle Practices

• Pace activities carefully - Use energy conservation strategies, break tasks into smaller segments, alternate activities with rest, and avoid pushing beyond limits, which worsens symptoms
• Prioritise sleep hygiene - Maintain consistent sleep-wake times, create a dark, cool, quiet bedroom environment, avoid screens before bed, and develop relaxing bedtime routines
• Practice gentle daily movement - Engage in low-impact activities like walking, swimming, tai chi, or gentle yoga, starting slowly and gradually increasing as tolerated
• Apply heat therapy - Use warm baths, heating pads, warm packs, or heated pools to relax muscles, reduce pain, and promote comfort
• Manage stress actively - Incorporate daily relaxation practices such as deep breathing, progressive muscle relaxation, guided imagery, or meditation
• Maintain social connections - Stay engaged with supportive friends, family, or fibromyalgia support groups to reduce isolation and maintain perspective
• Eat an anti-inflammatory diet - Focus on whole foods, colourful fruits and vegetables, omega-3 fatty acids, and minimise processed foods, sugar, and potential trigger foods
• Practice good posture - Be mindful of body positioning during activities, use ergonomic support, and avoid positions that increase pain or stiffness
• Keep a symptom journal - Track pain levels, activities, sleep, stress, weather, and foods to identify patterns and triggers
• Set realistic expectations - Accept limitations without self-judgment, celebrate small accomplishments, and adjust expectations based on daily capacity

When to Seek Professional Support

Conventional medical practitioners should be consulted for proper diagnosis through evaluation of symptoms, medical history, and ruling out other conditions such as rheumatoid arthritis, lupus, or thyroid disorders; management of fibromyalgia with appropriate medications including pain relievers, antidepressants, or anti-seizure drugs that modulate pain pathways; treatment of co-existing conditions such as sleep disorders, depression, or anxiety; referral to specialists when needed; and monitoring of symptoms and medication effectiveness. Medical attention is important when experiencing new or worsening symptoms, severe depression or anxiety, medication side effects, significant functional decline, or symptoms suggesting other conditions requiring medical evaluation. Immediate care is needed for severe depression with suicidal thoughts, chest pain, severe abdominal pain, or any emergency symptoms.

A verified SoulAdvisor practitioner can work collaboratively with medical providers to provide gentle, effective complementary care recognising that integrative approaches for fibromyalgia require multifaceted treatment addressing the physical, emotional, neurological, and lifestyle dimensions of the condition, that gentle, body-respecting approaches are often more effective than aggressive interventions, that pacing and self-compassion are essential for sustainable improvement, and that combining conventional medical care with appropriate TCIH modalities offers the best opportunity for reducing symptoms, improving function, enhancing quality of life, and supporting individuals in living well despite this challenging chronic condition.