Manage Fibromyalgia Flare-Ups and Get Back to Enjoying Life

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If you are one of the four million individuals in the United States struggling with fibromyalgia, you already know that stress impacts your quality of life.

A family reunion, a friend’s wedding, and a deadline at work are everyday life events. Why would events like these be linked to a flare-up in fibromyalgia pain? Understanding the connection between emotional arousal and chronic pain is vital to both the prevention and management of fibromyalgia pain.

Those with fibromyalgia struggle with symptoms of widespread pain, tenderness, sensitivity to vibration, pressure, and touch (hyperalgesia and allodynia); muscle stiffness; memory problems; and difficulty concentrating. Yet, these symptoms come and go for most sufferers, making it hard to diagnose and treat. This is where the connection between stress and emotions plays a critical role in pain flare up.

The Brain Map for Pain

Even if you do not have chronic pain issues, you may have already experienced a link between stress, emotional arousal, and pain.

You may have an old injury, like a badly sprained ankle from back in high school. Years later, you are traveling overseas and have just missed your connecting flight and lost your way in an unfamiliar airport. As you frantically search for a help desk to rebook your flight, you notice you are painfully hobbling as you rush through the terminal. The sensations from that old ankle injury, which healed 20 years ago, are back again.

Rather than thinking of negative emotions causing pain, viewing emotional arousal as linked to pain is more accurate and leads to helpful management strategies.

Picture the brain as a spiderweb or neuromatrix of connections that include physical sensations, memories, sights, sounds, emotions, thoughts, and behavior. When the brain registers a threat that warrants protection, it produces a warning so that we become aware of the danger. The warning often comes in the form of physical pain.

Stimulating any single part of the spiderweb will activate the entire matrix. This means that an old ankle injury, which was originally linked with very specific cognitive, motor, sensory, and emotional elements, can lead to a similar threat state that produced the pain 20 years ago simply by experiencing another stressful physical event. All we need to do to create pain is stir up those specific circuits in the brain map that initially produced the state of threat. Once the brain registers a threat, pain will result.

Understanding the neuromatrix gives clues to unlinking the connection between stress, emotions, and pain.

The Art of Noticing

We have a skill worth unlearning—the skill of being on autopilot. We are excellent at going through our day without being aware of the events that trigger stress, what we think about those events, the emotions we experience based on our thoughts, the memories linked to those thoughts, events, and emotions, and where those emotions are experienced throughout our body.

Our lack of awareness is complicated by the fact we often learn how to turn off our emotional awareness when we are overwhelmed by distress.

Fortunately, increasing awareness is a skill we can learn with practice.

Even though the brain monitors thousands of processes, picturing the brain as four primary domains can help us increase our awareness so that we can monitor, evaluate, and modify its activity. In doing this, we can reduce the influence of old maps that trigger pain and rewrite new flexible and adaptive maps.

Getting Started

Picture yourself sitting in the middle of a large circle—the circle has four areas where you will direct your attention, one section at a time. The sections involve our five senses, physical sensations, mental activity, and social connections.

1. Five Sense Experiences: Notice what you see, hear, sense with your body, smell, and taste. Take as much time as you would like to focus on the here and now and do your best to suspend judgment and mental commentary.
2. Physical Sensation: Notice the physical sensations within your body, starting with your feet and reaching your head. See if you recognize any emotions connected with these sensations or areas of your body.
3. Mental Activity: Direct your attention to your thoughts and emotions. Try to notice your thoughts and emotions with openness, curiosity, and kindness. If there are memories associated with your thoughts and emotions, look at the memories as you would look at interesting items in a museum. Also, pay attention to your emotional needs for safety, belonging, autonomy, and competence. Are you happy, satisfied, and content? Think of your emotions as a gauge letting you know if you feel safe and connected or if wrong or injustice is present.
4. Social Connections: Focus on the important people in your life and your sense of belonging, closeness, and connection. When noticing these relationships, spend a moment wishing each of these individuals well. Take a moment to practice being grateful for the people in your life, including yourself.

With practice, this mindfulness exercise can help you loosen the connection between stressful events, emotional arousal, and increased pain by putting your mind in the driver’s seat of your life. This skill is similar to what a person who has experienced a terrible car accident must do to regain confidence and composure when driving on a highway. Their brain has an old map that is triggered by the sights, sounds, and smells of driving that stir up anxiety and fear.

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Mindfulness skills can help us shift from being reactive to these associations to becoming receptive. In a receptive state, we can proactively evaluate and modify the map, taking charge of our well-being.

To get started, you can use this short audio guide to practice this mindful exercise. As always, remember to be kind to yourself as you learn a new way of thinking and going through life. We have years of practice being on autopilot, and it takes time to learn new skills.