How osteopathy offers relief to people with fibromyalgia and chronic fatigue

The connection between mind and body, and the support available


If you or someone close to you suffers from either fibromyalgia syndrome (FMS) or chronic fatigue syndrome (CFS), you’ll know the significant impact it can have on quality of life and the ability to carry out everyday activities. While fibromyalgia causes widespread pain, chronic fatigue causes severe exhaustion. Both conditions can also cause difficulties with memory, digestive challenges, insomnia, anxiety, depression and more. What makes these conditions more distressing is that the collection of symptoms cannot be medically explained – doctors cannot find a precise cause for fibromyalgia syndrome or chronic fatigue syndrome (also known as myalgic encephalomyelitis).

Both conditions are thought to be triggered by either an injury, acute episode of stress, or infections like Covid or Epstein Barr Virus. But most people would recover from these within a few days to weeks. So, why do some go on to develop long-term conditions like fibromyalgia or chronic fatigue?

Emerging scientific research shows an undeniable link between your mind and body. The chronic debilitating symptoms you’re experiencing are real – they’re not ‘in your head’, which some may have you believe; instead, they’re in your brain, which means they can be cured.

Fibromyalgia and chronic fatigue are psychophysiological disorders (PPD). 

Psychophysiological Disorders (PPD) is the clinical term for mind-body symptoms. Our entire brain is connected and communicates through neural pathways (like highways between cities). These pathways form the basis of our habits of thinking, feeling, and behaving. They create every sensation we feel in our body. One of these neural pathways is called the danger-alarm system, that alerts us to potential danger. It’s designed to keep us safe, to keep us alive. It serves an importance purpose.

But, when a child grows up afraid, in a highly stressful environment, the body and brain’s system become more sensitised to threat, real or perceived. Later, when the child or adult is exposed to even ordinary levels of stress, these systems may respond automatically – as though the person is under extreme stress. They may experience the heart pounding, rapid breathing, or shut down completely.

While other responses include fatigue (chronic fatigue syndrome), difficulty managing emotions, explosive anger, anxiety, depression and insomnia, and irritable bowel syndrome, pain is the brain’s most common response to threat.

When danger signals disappear, your body should ideally return to a state of relaxation and calm. But, if your danger alarm mechanism is being activated longer than it should or in response to perceived threats, your brain can generate chronic pain and other symptoms, keeping you stuck in a constant state of alarm.

The symptoms of fibromyalgia and chronic fatigue don’t appear due to tissue damage, rather due to overactivation of your danger-alarm system. Unfortunately, the more we focus on our symptoms, such as fatigue or pain, the more our brain receives a signal that there is something wrong with us. It directly activates the danger response and the vicious cycle continues until it becomes a learnt and engraved pathway in the brain that is triggered more and more frequently.

Know this: all tissues heal and scars don’t hurt. If you’re experiencing pain or other debilitating symptoms that persist more than three months after an acute injury, it is almost always linked to mind-body symptoms. Chronic pain, migraine, fibromyalgia, chronic fatigue and pelvic pain syndromes are just a few of the very real chronic conditions that can be diagnosed as PPD.

How osteopathy can help in the treatment of psychophysiological disorders

Researchers from John Hopkins hospital have reported that 40-80% of chronic pain patients are misdiagnosed. All-too-often, the cause of pain is misdiagnosed as a structural tissue issue.

Again, by focussing on a physical cause of pain and dysfunction, we’re being told there is something wrong with our bodies, which signals the brain that there is something wrong and activates the danger-alarm system, causing even more pain and dysfunction.

You are not broken – instead, you may be trapped in a neural circuit that perpetuates your experience.

Osteopathy can help.

Qualified osteopaths are trained to identify if your pain is connected to a structural cause such as a fracture or ligament tear, or if you’re suffering from PPD. They’re trained in pain science and have the tools to help you truly understand your pain and the triggers.

Having the knowledge and reassurance that your pain is real but not a structural problem can be healing. Understanding your pain can reduce your pain intensity.

This theory is validated by science. Dr. Howard Schubiner heads a mind-body medicine program at Providence Hospital in Michigan. In a study of 45 women with fibromyalgia, he found that those who learned a technique called “affective self-awareness” were more likely to show a significant reduction in their pain over a six-month period. 46 percent of the women had a 30-percent or greater reduction in their pain severity. In comparison, those who were assigned to a wait-list for therapy did not show a decline in pain severity.

Your osteopath can use manual therapy techniques to relax your nervous system and dampen the danger-alarm response. Having some pain and fatigue relief for a few hours can open a window of opportunity to start to rewire your brain, and get you started on the road to recovery.

But, if you’re struggling with chronic recurrent symptoms, a skilled osteopath will not solely rely on manual interventions. As PPD is associated with anatomical changes in the brain, retraining your brain is key. This requires an active, participatory approach on your side that cannot be achieved through passive interventions.

You don’t need to do this on your own. Your osteopath can coach you through pain reprocessing techniques and teach you effective stress management strategies including meditation and other mindfulness exercises. And they will help you return to movement and exercise in a paced manner to avoid symptom flare-ups.

Taking an integrated approach to your healing, your osteopath might – with your agreement – refer you to a mental health therapist skilled in supporting clients with a history of trauma. Trauma often occurs in unhealthy relationships; healing occurs in safe relationships.

Are you stressed? 

You may think this all sounds interesting, but it doesn’t refer to you as you don’t feel stressed. The reality is our bodies and brains are not designed for modern 21st century living. Rushing to work, constant notifications and emails, lack of sleep and exercise as well as the constant uncertainties that the pandemic has brought to our lives can all be perceived by the brain as stressors and threats. Also certain personality types like high achievers, people pleasers, and worriers are more likely to develop chronic pain and fatigue. So our brain can be stressed without us consciously experiencing stress.

Fortunately your brain, and its neuronal networks, are very much flexible. This is called neuroplasticity. Working together with an Osteopath who specialises in this area of work will help you understand your pain and teach you lifelong skills to move your nervous system from a state of danger-alarm to relaxation and ease to enable you to live pain-free and energised.

If you or someone you know is experiencing chronic pain, fatigue, or discomfort, please know support is available. At IMI, we take an integrated approach to healing to identify the underlying cause of chronic conditions and create personalised, sustainable treatment plans that address all facets of your wellbeing for optimal healing.

To schedule a consultation with one of our Osteopaths, please call +852 2523 7121 or connect here.


Chinese version 中文版


纖維肌痛綜合症(FMS)和慢性疲勞綜合症(CFS)都是原因不明的疾病。纖維肌痛引起廣泛的疼痛,而慢性疲勞則引起嚴重的疲憊。兩者有許多臨床常見的共同病症,如憂鬱症、焦慮症、睡眠障礙、疲勞無力、頭痛、顳顎關節障礙症、麻痺刺痛、大腸急躁症、善忘、無法專心等,這些症狀會大大降低了患者的生活品質。這兩種情況到目前為止醫學上都無法解釋。相信是由受傷、急性壓力或感染(如Covid或Epstein Barr病毒)引發的。大多數人都會在幾天到幾週內恢復過來。但有些人的症狀卻會持續很久。近年的科學研究證明,我們的身心之間存在著緊密的聯繫。很多慢性衰弱症狀都是由心理引發的。

心理生理障礙(PPD)是心身症狀的臨床術語。我們的大腦由很多神經通路連接和交流着。這些路徑構成了我們思想、感覺和行為習慣。其中一個重要的神經通路被稱為”危險警報系統”,提醒我們要注意潛在危險, 確保我們的安全。

但當一個人兒時在高度緊張或害怕的環境中成長時,身體和大腦系統對真實的或感知的威脅就變得很敏感。日子久了, 當他遇到壓力時, 身體的神經”危險警報系統” 就會作出自我保護反應。出現心跳加促,呼吸急促甚至自行關閉身體某些機能。疼痛是大腦對威脅最常見的反應。其他反應包括疲勞(慢性疲勞綜合徵)、難以管理情緒、憤怒、焦慮、抑鬱和失眠,以及腸易激綜合症。

正常情況下, 當危險信號消失時,身體很快便能恢復到放鬆和平靜的狀態。但是,當身體的危險警報機制被激活過久, 大腦就會產生慢性疼痛和其他症狀,使我們陷入持續的警報狀態中。

纖維肌痛和慢性疲勞的症狀都不是由組織損傷而引致的,而是由於身體的危險警報系統被過度激活。當我們越關注身體的症狀,如疲勞或疼痛,大腦就越收到身體有問題的信號, 從而再激活危險反應, 做成了惡性循環。

一般傷口癒合後是不會感到痛楚。但如果傷口癒合後, 身體的疼痛或其他症狀仍然持續三個月以上,就很可能與心身症狀有關。慢性疼痛、偏頭痛、纖維肌痛、慢性疲勞和盆腔疼痛綜合症都是屬於心理生理障礙(PPD)。

John Hopkins hospital的研究人員報告,有40-80%的慢性疼痛患者被誤診為結構性組織問題。慢性疼痛錯誤地向大腦發出了信號,並激活了危險警報系統,導致更多的身體疼痛和功能障礙出現。

IMI的整骨治療師受過專業的疼痛科學培訓, 能夠識別身體的疼痛是否與結構性原因如骨折或韌帶撕裂有關, 或是患有PPD。了解疼痛的根源對治療有很大幫助, 可以大大減少疼痛幅度。

Dr. Howard Schubiner 是密歇根州Providence Hospital的心身醫學項目負責人。他對45名患有纖維肌痛的婦女進行研究,他發現那些學習了一種叫做 “情感自我意識 “技術的人, 她們的疼痛在六個月内明顯減少。 46%婦女的疼痛嚴重程度大幅減少了30%甚至更多。而那些被分配到等待治療的人, 疼痛嚴重程度並沒有改善。


專業整骨治療師會通過”傷痛後處理技術”去指導您有效地應對壓力,包括冥想和其他正念練習。幫助您以有節奏的方式恢復運動和鍛煉,以避免症狀發作。如有需要, 整骨醫師還會轉介客人給心理健康治療師提供專業支援。


幸運的是,我們的大腦和神經網絡非常靈活。它可以根據身體面對的各種壓力和經歷,來調節神經線,以控制肌肉和手腳協調的功能。這種能力稱為「神經可塑性」。專業的整骨治療師能夠幫助你了解身體的疼痛問題,並給予指導, 使神經系統從危險警報狀態轉向放鬆。如果你或身邊的人正受到慢性疼痛、疲勞等不適情況困擾,請與IMI聯絡。我們會採取綜合的治療方法,以確定慢性病的根本原因,並製定個人化的治療方案去解決你所有健康方面的問題。

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