“I have heard that Fibromyalgia does not involve any tissue damage or known pathology. However, I still experience pain despite the absence of tissue damage. Why is this so?”
Many people believe that pain is only felt in the presence of tissue damage. Nevertheless, recent research has demonstrated that the pain mechanism is a complicated neurophysiological process. Chronic pain may occur due to a pain processing disorder (how pain signals travel to the brain) and pain perception disorder (how pain signals are perceived by the brain) without any tissue damage. This phenomenon is known as central sensitization.
I have Fibromyalgia, am I imagining my pain?
No, you are not.
The Pain perception is real though it is not due to tissue damage. The reason one feels the pain is due to the way nervous system processes the sensory signals, their transmission along pain pathways and eventually how those signals are perceived by brain.
Is it true that Fibromyalgia causes pain due to a “brain disorder” ?
No, this is not true. Brain scans are essentially normal. However, recent functional imaging studies have found abnormal pain processing activities in the brain which could explain the central sensitization pain mechanism.
Patients are often told that “pain is in your head” or “your brain is imagining pain.” This phrase refers to the dysfunction in pain processing and pain perception.
Unfortunately, patients often misconstrue this to mean that their pain is a result of a psychological issue. This is far from the truth but results from a complex neurophysiological process.
I will try to give the analogy – Hope you can see the distorted image of bananas…..
Although there is no damage to the physical shape of the bananas and no abnormalities in your eyes, you are still perceiving a distorted image that is very real, like how pain sensations are experienced as real. This distortion is not a result of psychological problems but rather how the image is processed and presented to your eyes through the glass of water. Just as we see what is presented to us and not the actual shape of the bananas, our brain can register non-painful stimuli such as touch, pressure, or movement as painful signals due to misrepresentation. Moreover, even mild and tolerable painful stimuli can be amplified, causing them to be perceived as severe pain.
So in summary it is neither a structural disorder of brain tissue nor a psychological issue but one of perception due to changed pain mechanics
Hope this gives you more insight into the problem.
Girivasan Rajarathinam
MSc (UK), MACP, HCPC (UK)
UK-Trained experienced specialist physiotherapist in Dubai
IRAC is offering a Free ‘Fibromyalgia patient awareness and education’ session. If you are diagnosed with Fibromyalgia and willing to know about the current physiotherapy related research evidence (Evidence Based Practice), please send us your interest in the email with your phone number and we will contact you.
IRAC MSK Center, Dubai Healthcare City, Dubai – UAE.
Call +971 4 456 8952 Chat +971 56 875 9661
email: giri@iracdubai.com
102 & 105, 1st floor, Building 47 Dubai Healthcare City, P.O. Box 334224
