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 Maxi, please call +852 2523 7121 or connect here.
About the author
Maxi Schönteich is a UK-trained Osteopath, Paediatric Osteopath, Nutrition Therapist, and the only female Certified Functional Medicine Practitioner in Hong Kong. Blending her expertise, Maxi is appreciated by clients for her ability to identify and holistically treat the underlying, often hidden, causes of complex pain conditions that can be misdiagnosed and inappropriately treated for years. Maxi treats clients of all ages – from new-borns to growing children and adults to older people.
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。
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。