Fibromyalgia: Identifying Patterns for Immediate Symptom Reduction

Fibromyalgia is often regarded as a lifelong pain condition with limited therapeutic options. However, emerging clinical observations suggest that certain patients may experience significant symptom relief when specific neurophysiological patterns are addressed. Hyper-mobility as a Key Feature A striking observation in fibromyalgia is the strong association with joint hypermobility. Patients frequently describe themselves as “very bendy” or unusually flexible, reflecting underlying connective tissue differences. Research supports this link: Eccles and colleagues (2012) reported that up to 80% of individuals with anxiety disorders are hypermobile, while in fibromyalgia the prevalence approaches 99% (Sendur et al., 2007). Hypermobility may increase vulnerability to central sensitisation and autonomic dysregulation. The Role of Autonomic Sensitisation Fibromyalgia can be understood as a disorder of autonomic nervous system (ANS) imbalance, characterised by a state of persistent sympathetic arousal and parasympathetic withdrawal (Martínez‐Martínez et al., 2014). This dysregulated “set-point” manifests as smooth muscle hyper-tension, widespread pain, and sensory hypersensitivity. Critically, patients often identify a period in life when symptoms first emerged, typically linked to an event of significant emotional vulnerability or distress. Such memories, particularly those formed in childhood, exert a disproportionate effect on autonomic reactivity (van der Kolk, 2014). Therapeutic Considerations: Memory and Consent An important clinical question is whether the patient wishes to reduce the body tension generated by distressing memories. If the response is hesitant or ambivalent, proceeding with intervention may not be advisable. For successful outcomes, patients must actively “own” the shift into a new autonomic equilibrium. Manual therapy in this context does not directly “treat” fibromyalgia, but rather modulates the autonomic imbalance underlying its expression. The therapeutic aim is to evoke a parasympathetic state sufficiently strong to disrupt the entrenched sympathetic dominance. Manual Therapy and the Dive Reflex The mammalian dive reflex provides a natural physiological pathway for such modulation. Triggered by contact of the face or body with water, this reflex induces bradycardia, peripheral vasoconstriction, and enhanced vagal activity (Panneton, 2013). By applying water or copper interfaces—both diamagnetic and dielectric materials—to the cranial or sacral regions, practitioners may enhance parasympathetic dominance during treatment. Clinical Method

1. Evoke sympathetic arousal: The patient recalls a personally significant negative memory, thereby inducing measurable tissue tension. 
2. Apply dive reflex stimulation: The head rests on a water- or copper-based interface (“pillow”), while the practitioner applies gentle cranio-sacral compression over the tight cranial tissue. 
3. Guide tissue release: As the practitioner follows tissue resistance, a sudden “collapse” of tension may be felt.
4. Reassess memory–body link: On revisiting the same memory, the previously induced tension is reduced or absent.
5. Repeat as required: Successive distressing memories may be processed in this way, with cumulative reduction in fibromyalgic tension.

Patients vary in responsiveness. If no change occurs after the first session, further sessions are unlikely to yield substantial improvement. Conclusion Fibromyalgia appears to represent a fixed autonomic equilibrium of sympathetic overactivity. By utilising the dive reflex in conjunction with manual therapy, practitioners may create a parasympathetic window in which maladaptive memory–body couplings collapse. For selected patients—particularly those with hyper-mobility—this approach may provide meaningful, sometimes immediate, symptom reduction. What I am mindful of!  It is a common error to make “adult” conclusions of “childhood” memories and so ignore or overlook the “Loss of a Teddy event” if the adult remembers an event from childhood, that event was most likely very  important to “that child”. Respect and honour the ‘Memory’ and see if it brings in ‘excessive’ sympathetic tension, if it does not, more onto the next ‘Memory” in the list. Do not pre-judge a recalled memory, you are the not the judge the body tension is, one works with what the body give you! References

• Eccles, J. A., Beacher, F. D., Gray, M. A., Jones, C. L., Minati, L., Harrison, N. A., & Critchley, H. D. (2012). Brain structure and joint hypermobility: relevance to the expression of psychiatric symptoms. British Journal of Psychiatry, 200(6), 508–509.
• Martínez‐Martínez, L. A., Mora, T., Vargas, A., Fuentes‐Iniestra, M., & Martínez‐Lavín, M. (2014). Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: A review of case–control studies. Journal of Clinical Rheumatology, 20(3), 146–150.
• Panneton, W. M. (2013). The mammalian diving response: An enigmatic reflex to preserve life? Physiology, 28(5), 284–297.
• Sendur, O. F., Gurer, G., & Bozbas, G. T. (2007). The frequency of hypermobility and its relationship with clinical findings of fibromyalgia patients. Clinical Rheumatology, 26(4), 485–487.
• van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.