Understanding Fibromyalgia: When the Brain Turns Up the Volume on Pain

Fibromyalgia is a chronic condition that can cause pain, fatigue, and sensitivity throughout the body. We see and treat a lot of patients at ADT Chiropractic in Cardiff who suffer from this condition, and although it’s often misunderstood, research suggests it’s primarily a problem with how the central nervous system (the brain and spinal cord) processes pain signals - not necessarily an issue in the specific body parts where pain is felt. Let me explain,

Imagine your knee starts to hurt. You’d naturally think the pain is in your knee, right? What you actually “feel” is the pain in your brain, specifically in an area called the sensory cortex.

The sensory cortex is like a detailed map of your entire body. It receives and interprets sensory information - things like touch, temperature, vibration, and pain from every inch of your body. Some body parts are allocated small sections like your elbow and some parts are allocated large sections of the brain, such as your fingers and face.

For pain to travel from your knee to your brain, it must pass along three different nerves (Black lines). Between each nerve is a tiny gap, or synapse (as shown by the red circles below), where the pain signal “jumps” across using chemical messengers called neurotransmitters - typically glutamate or substance P.

Now, why is all this important when talking about fibromyalgia? Because it helps explain the widespread nature of the condition, based on 2 main areas,

• Physical

• Psychological

  
  

Physical

Your experience of pain depends partly on how much neurological activity is being transmitted physically to the brain. If you suffer a major injury, a larger amount of neurological activity floods the system and you can feel a more intense pain. With a minor injury, there’s far less neurological activity, so the pain is milder, but if you have many mild pain sources (as in fibromyalgia), the combined effect can overwhelm the sensory system, lowering your pain threshold and amplifying how severe the pain feels, In other words, your brain begins to overreact to pain signals, perceiving even mild sensations as painful.

Here’s where it gets even more interesting. The brain actually physically changes based on the signals it receives - a process known as neuroplasticity.

You’ve probably heard the saying “use it or lose it” or “practice makes perfect.” That’s neuroplasticity in action. If you practise a skill, like catching a ball, the area of the brain responsible for that movement becomes more active and grows. If you stop practising, that area shrinks, and the skill fades. Pain works the same way. If pain signals keep stimulating the same part of the brain over a long time, that area can grow and become more sensitive and efficient at processing pain making it easier to trigger and harder to switch off.

This is why chronic pain can continue after the original injury has healed or is healing. A powerful example is the phenomenon called "The phantom limb". This is when someone who’s had an amputation still feels pain in the missing limb! The limb may be gone, but the part of the brain that represented it is still present and active, firing off pain signals making the amputee still experience pain in that limb.

Psychological

Pain isn’t just a physical sensation it’s also deeply emotional and psychological.

Think about some of these everyday experiences:

• You discover a bruise or small cut after someone points it out and suddenly, it starts to hurt.

• You get injured while playing sport and you continue playing but don’t realise how bad it is until the game’s over and the adrenaline wears off.

• You stub your toe when you’re stressed, exhausted, and hungry maybe while moving house and it feels excruciating. But if the same thing happens when you’re out and about laughing with friends, it would barely register.

  
  

In each situation, the pain signal itself doesn’t change what changes is your brain’s emotional state.

When you’re stressed, anxious, or run down, your brain becomes more sensitive to pain signals.

Both emotional stress (like anxiety, depression, or mental fatigue) and chemical stress (such as poor diet, dehydration, or nutrient deficiencies) can heighten your perception of pain. That’s why it’s so important to manage the factors you can control like rest, hydration, nutrition, and stress levels to give your body the best chance to cope and recover.

How Fibromyalgia Is Diagnosed?

According to the Royal College of Physicians, fibromyalgia is diagnosed using two main criteria:

1. Symptom Severity Score (SSS) - This rates three key symptoms:

   • Fatigue

   • Trouble thinking or remembering

   • Waking up tired

   Each is scored from 0 to 3, and the total must be greater than 5 to meet the first part of the criteria.

2. Widespread Pain Index (WPI) - This measures how many areas of the body experience pain.A person must have pain in at least 7 out of 19 specific areas, often located at characteristic pressure points around the body.

   
   

Using those criteria, it’s easy to see why many people might feel like they meet the definition most of us could probably tick a few of those boxes on a bad day!

How can Chiropractic help?

At ADT chiropractic based in Cardiff we help by addressing one thing at a time, what we call the one percenters. We look at the list of things that are causing pain/discomfort and start to address them one by one, slowly increasing your bodies capacity to absorb the biomechanical load thats causing your pain. Once we start to address this everything will slowly start to fall in to place...pain will reduce, your nervous system will calm down, and tolerance will increase, you'll have better sleeps, feel less fatigued, actually start to feel like there is something that can be done to help you...

I know this probably the longest blog ive written to date so if you made it to the end well done! Please get in touch if you or someone you know is suffering and has any further questions

The Team

ADT Chiropractic

Cardiff