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  • Dr. Kelly Ashbeck


Updated: Jul 25, 2022

Fibromyalgia - Why do I have pain?

I have been treating individuals with fibromyalgia long enough to have heard complaints that clinicians have shrugged off this diagnosis as somehow “made-up.” But isn’t that what we do when we simply don’t understand a diagnosis - our egos tell us it must be made up. Science has come a long way in understanding fibromyalgia and thankfully the medical community has for the most part, picked up on this science. So what exactly is this science?

What we now know occurs in individuals with fibromyalgia is that there is abnormal pain processing that occurs within the nervous system. In other words, danger signals throughout the body become amplified. What we don’t fully understand is why this amplification, called central sensitization, occurs in those with fibromyalgia. Fibromyalgia symptoms can be the product of childhood trauma or PTSD, which makes sense that the nervous system would have become over-protective and sensitized. Others with fibromyalgia may link their trigger to other medical conditions such as a virus or chronic infection. And yet others may not be able to pin-point the trigger to their symptoms at all. But understanding that fibromyalgia fits under the umbrella of central sensitization, we are able to better understand appropriate treatments.

Education: It is always good to have a better understanding of why you have pain. That can especially be true when your pain isn’t obvious to others. This was the trouble when so many clinicians refused to believe fibromyalgia was real but can also be frustrating when it may take months or years to get a diagnosis.

Activity pacing: I have previously blogged on activity pacing and if you are interested, I would strongly encourage you to check out that post. But in general, it is important to understand activity pacing to avoid flare-ups in your pain. Remember that fibromyalgia is a condition in which danger signals are amplified within the nervous system, thus “pushing through pain” often results in a pain flare because your nervous system is simply trying to protect you. By slowly introducing certain activities or vigor within already introduced activities, you are allowing your nervous system to adapt.

Exercise: What we know about fibromyalgia is that there can be overlap with other conditions. Thus, if you have been diagnosed with Chronic Fatigue Syndrome (much different than general fatigue and deconditioning), I would encourage you to read my previous blog post on CFS. Why? Because exercise treatment for CFS is much different than that for Fibromyalgia. With fibromyalgia, aerobic exercise is one of your best lines of defense. Aerobic exercise has been known to improve symptoms of anxiety and depression (which are common in those with fibromyalgia) but can also quiet down the noise that exists when signals within the central nervous system are amplified (aerobic exercise positively influences central sensitization).

Manual Therapies: To help you tolerate the above activities, massage, dry needling and joint mobilizations can all be utilized in physical therapy. All of these techniques, when combined with education, activity pacing, and exercise, can help you regain control of yourself and your activities.

If you have been diagnosed with or suspect that you have fibromyalgia, reach out to me at or call to set up a free consultation. If you’re ready to get rolling on treatment, schedule your initial evaluation either online or by calling (920) 931-2532.

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