Emotional reasons for fibromyalgia

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Written By Dr. Marcus Yu Bin Pai

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Fibromyalgia is a complex and often misunderstood condition characterized by a cluster of symptoms that primarily affect the nervous system. This condition typically impacts women, but men can also experience it.

Many people may not realize the significant connection between their mental and physical health. In this article, we will discuss the importance of the mind-body connection and how it impacts our overall well-being and painful conditions such as Fibromyalgia.

The Power of the Mind

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The mind is a powerful tool that can influence our physical health in various ways. The placebo effect, for example, illustrates how our beliefs and expectations can impact our experience of pain.

When given a sugar pill without any active ingredients, patients who believe it will alleviate their pain often report experiencing relief.

This phenomenon goes beyond just a psychological effect, as objective measures such as heart rate and blood pressure also show improvement.

Mental Health and Physical Symptoms

As a society, we often prioritize finding physical explanations for our ailments. When we cannot pinpoint a specific cause, we tend to label these conditions as idiopathic or unknown in origin. However, it is essential to consider the role that mental health plays in the development of physical symptoms.

Research has shown that our minds can create physical symptoms as a way to distract us from powerful emotions, effectively repressing these feelings. As these emotions continue to be suppressed, they can overflow and cause more complex symptoms.

Causes of Fibromyalgia

The exact cause of fibromyalgia remains unknown, but it is believed to be related to an abnormality in the nervous system, which affects the body’s ability to process pain messages. This results in heightened sensitivity to pain.

Fibromyalgia can develop at any point in one’s life and is often triggered by significant emotional trauma or stress, although not always.


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Some of the challenges faced by those living with Fibromyalgia include:

1. Invisible Pain:

One of the most distressing aspects of fibromyalgia is the invisible pain it causes. This widespread pain isn’t like an acute injury; it’s a constant, nagging sensation that can be exhausting and overwhelming.

Despite looking fine on the outside, people with fibromyalgia may be in excruciating pain on the inside.

2. Fatigue:

In addition to pain, people with fibromyalgia often experience debilitating fatigue. Managing pain can be mentally and physically exhausting, making it difficult to perform daily activities and maintain a normal routine.

3. Guilt:

Many fibromyalgia sufferers experience feelings of guilt, stemming from an inability to meet self-imposed expectations or fulfill their roles in family, work, or social settings. This guilt can compound the emotional toll of living with the condition.

4. Brain Fog:

Cognitive difficulties are common among those with fibromyalgia, often referred to as “brain fog.” This can manifest as difficulty concentrating, memory problems, and trouble processing information, which can be both frustrating and frightening for those affected.

5. Worry and Frustration:

Anxiety and worry are common among fibromyalgia sufferers, often stemming from concerns about their pain, fatigue, and ability to function in daily life. This can lead to feelings of frustration and a sense of being stuck, exacerbating the emotional burden of the illness.

6. Lack of Understanding:

One of the most challenging aspects of living with fibromyalgia is the lack of understanding from others, including family, friends, and even medical professionals.

This can lead to feelings of isolation and frustration, as people with fibromyalgia struggle to find support and empathy for their condition.

7. Grieving the Loss of the Old Self:

Many people with fibromyalgia grieve the loss of their former selves and the lives they once led. This can be an incredibly emotional process, as they come to terms with the changes brought about by the illness and adapt to a new normal.

Symptoms of Fibromyalgia

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The symptoms of fibromyalgia can range from physical to cognitive, including:

  1. Fibro fog: This term refers to the difficulty in thinking and concentrating experienced by fibromyalgia patients, often accompanied by a feeling of disconnection from one’s body.
  2. Pain and tenderness: Patients often experience pain in various parts of the body, including the temples, jaw, neck, back, shoulders, elbows, wrists, hips, knees, and ankles. These tender points are not exclusive to fibromyalgia, and patients may also experience other pain-related conditions.
  3. Gastrointestinal issues: Fibromyalgia patients often suffer from irritable bowel syndrome (IBS) or an overactive bladder, leading to frequent trips to the toilet.
  4. Sleep problems: Difficulty in falling asleep and poor sleep quality are common issues faced by fibromyalgia patients.

Approaching Patient Care with a Holistic View

Incorporating mental health questions into the diagnostic process can lead to more successful treatment outcomes. By understanding the patient’s emotional state and the potential impact on their physical health, healthcare providers can offer more comprehensive care.

When treating patients with pain or other physical symptoms, it is crucial to explore their mental state as well. Inquiring about their current life situation, childhood experiences, and emotions can help identify potential psychological contributors to their symptoms.

Managing Fibromyalgia

Effective management of fibromyalgia requires a multi-faceted approach, including:

  1. Psychological support: Working with a psychologist can help patients rewire their brain to better manage pain and improve overall mental health.
  2. Medication: Nerve painkillers can help improve sleep quality and reduce pain symptoms in fibromyalgia patients.
  3. Physiotherapy: A specialist physiotherapist can design a graded exercise program to help patients gradually increase their activity levels.
  4. Lifestyle adjustments: Patients should focus on improving their sleep quality rather than increasing the duration of sleep, and finding ways to manage stress effectively.

The Importance of a Primary Care Doctor

Having a primary care doctor who practices with a holistic approach is essential for addressing the mind-body connection.

Primary care doctors who are familiar with your medical history and personal circumstances can better assess the potential impact of mental health on your physical well-being.

It is crucial for patients to be honest with their doctors about their emotions and mental state to receive the most effective treatment.


The mind-body connection is an essential aspect of our overall health that is often overlooked. By recognizing the influence of mental health on our physical well-being, we can seek more comprehensive and effective treatments for various conditions.

Fibromyalgia is a complex and multi-system condition that can significantly impact one’s quality of life. By understanding its symptoms and causes, and implementing targeted management strategies, individuals can regain control over their lives and experience a better quality of life.

It is essential to work closely with healthcare professionals who understand fibromyalgia and can offer appropriate support and guidance.

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MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

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