‘It’s all in your head’ was the usual phrase most people with Fibromyalgia, Chronic fatigue, elusive nerve pain, and other forms of Chronic and / or non-mechanical pain would hear. To which we respond: “Of course it is, where else would you expect it to be’! This is not an insult, it is a fact. Mechanical pain is the easy stuff! With a broken leg, a torn muscle or a herniated disk pain travels from injury sight to the brain and back again. The challenge is when that pathway becomes reversed or diffused! Here once again we look to the brain to see if there are classic EEG markers. We also look at the whole person. Brain-body pain, like all pain, is governed by the pain messaging systems –but some forms are highly intertwined with trauma and circumstance. With the EEG as our guide, we work to slowly unravel the braid. Unbinding pain from present and past towards a more comfortable future.
Brain-Body Pain Disorders (Fibromyalgia & Chronic Fatigue) - Quick Facts
- It was not too long ago that the field of medicine dismissed non-mechanical pain.
- Females with brain-body pain are disproportionality ignored.
- Brain-Body ailments now have very clear EEG signatures.
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Fibromyalgia, Chronic Pain and Chronic Fatigue
For pain conditions and chronic fatigue, please book a 5 point ClinicalQ intake with Dr Mari Swingle.
About the Conditions
Pain and fatigue are normal responses to injury and tiredness, however, either can become excessive or chronic due to a number of factors. There is a strong psychological component to chronic pain and fatigue conditions, firstly, because these experiences originate in the brain, which sends signals along nerve pathways to encourage us to avoid pain, rest, and recuperate, and secondly, because the nerve pathways that signal physical pain are also responsible for signaling emotional pain. As a result, chronic pain and fatigue conditions are distressing, and often exacerbated by the emotional exhaustion of living with these unpleasant sensations, day in day out, and because they are experienced more intensely, the more unprocessed emotional “baggage” we are carrying. This may be from past traumatic incidents, such as accidents, illnesses, or violence, or from emotional trauma, including trauma from childhood.
Recognizing the importance of psychological healing in chronic pain treatment does not mean you are imagining your pain – an unfortunate message that many fibromyalgia and other chronic pain and chronic fatigue patients have received by medical professionals. It means that effective treatment involves making both physical & psychological changes to long-standing patterns of thinking, feeling and behaving.
Recommended Neurofeedback Treatment
Pain often overlaps with emotional trauma. Trauma will typically show up as deregulation of the normal alpha wave (8-12hz) response of a 50% increase in alpha waves at the rear of the brain, between eyes open and eyes closed conditions. This alpha “blunting” is associated with a suppression of emotions, and often an impact on short-term memory. As well as being caused by traumatic and stressful events, pain is in itself a chronic stressor, causing constant tension and an inability to relax. This will typically show up as elevated fast frequencies in the beta and gamma range, particularly at the rear of the brain, combined with a deficiency of calming, slower frequency theta waves. Protocols to reverse these patterns, often conducted in a recliner with eyes closed, can help to re-train the brain to allow the client to relax / quiet, and get back in touch with repressed emotions and memories. Occasionally, an opposite pattern of excessive alpha waves is noted, more often associated with dissociation and difficulty staying present and grounded, again, often combined with patterns of anxiety and hypervigilance.
In addition, elevated delta and slower alpha waves are often observed in chronic pain and chronic fatigue. If these patterns are evident in the brain map, clients often report improved energy and pain patterns when trained down with Neurofeedback.
Many clients who have difficulty relaxing / quieting benefit from adjunctive peripheral biofeedback, such as heart rate variability and respiration training, and feedback on specific muscles that have been chronically tense. This helps clients to learn to integrate mental & physical relaxation. In addition, clients may benefit from Cranio-Sacral Therapy (CST), a gentle, hands-on manual therapy that releases tensions as well as restrictions deep in the body, which can develop over years of stress-related tension.
Typically, these adjunctive modalities will be integrated into a regular neurofeedback session with no additional charge.
Additional Recommended Psychological Services
Several psychotherapeutic treatments are helpful for supporting clients with chronic fatigue and chronic pain. Eye Movement Desensitization and Reprocessing (EMDR) can be particularly helpful with single incident traumas, such as car accidents, which are often a precipitating factor in chronic pain and fatigue. For more complex pain patterns, particularly those related to childhood illnesses or long-standing patterns of pushing oneself to the point of exhaustion, Schema Therapy can be helpful for changing long-standing life patterns. Counselling can also be a positive complement to Neurotherapeutic treatment.
Recommended Reading
Biofeedback for the Brain
Managing Pain Before it Manages You
Further reading...
Chronic Pain
Ahn, S., Prim, J. H., Alexander, M. L., McCulloch, K. L., & Fröhlich, F. (2019). Identifying and engaging neuronal oscillations by transcranial alternating current stimulation in patients with chronic low back pain: A randomized, crossover, double-blind, sham-controlled pilot study. The Journal of Pain, 20(3), 277.e1-277.e11.
Alm, Per A., and Karolina Dreimanis. “Neuropathic Pain: Transcranial Electric Motor Cortex Stimulation Using High Frequency Random Noise. Case Report of a Novel Treatment.” Journal of Pain Research, vol. 6, June 2013, pp. 479–86, doi:10.2147/JPR.S44648.
Bazanova, O.M., Aftanas, L.I. (2010). Individual EEG alpha activity analysis for enhancement neurofeedback efficiency: Two case studies. Journal of Neurotherapy, 14(3), 244–253.
Coger, R., & Werbach, M. (1975). Attention, anxiety, and the effects of learned enhancement of EEG alpha in chronic pain: A pilot study in biofeedback. Chapter in B. L. Drue, Jr. (Ed.), Pain Research and Treatment. New York: Academic Press.
Donaldson, C. C. S., Sella, G. E., & Mueller, H. H. (1998). Fibromyalgia: A retrospective study of 252 consecutive referrals. Canadian Journal of Clinical Medicine, 5 (6), 116127.
Gannon, L., & Sternbach, R. A. (1971). Alpha enhancement as a treatment for pain: A case study. Behavior Therapy & Experimental Psychiatry, 2, 209–213.
Ham, L. P., & Packard, R. C. (1996). A retrospective, follow-up study of biofeedback-assisted relaxation therapy in patients with posttraumatic headache. Biofeedback & Self-Regulation, 21(2), 93–104.
Jensen, M.P., Sherlin, L.H., Hakimian, S., Fregni, F. (2009). Neuromodulatory approaches for chronic pain management: Research findings and clinical implications. Journal of Neurotherapy, 13(4), 196–213.
Kayrian, S., Dursun, E., Ermutlu, N., Dursun, N., & Karamursel, S. (2007). Neurofeedback in fibromyalgia syndrome. The Journal of the Turkish Society of Algology, 19(3), 47–53.
Koberda, J.L., Koberda, P., Bienkiewicz, A., Moses, A., Koberda, L. Pain management using 19-electrode z-score LORETA neurofeedback. Journal of Neurotherapy, 2013, 17:3, 179-190.
Lehmann, D., Lang, W., & Debruyne, P. (1976). Controlled EEG alpha feedback training in normals and headache patients. Archives of Psychiatry, 221, 331–343.
Matthew, A., Mishm, H., & Kumamiah, V. (1987). Alpha feedback in the treatment of tension headache. Journal of Personality & Clinical Studies, 3(1), 17–22.
McKenzie, R., Ehrisman, W., Montgomery, P. S., & Barnes, R. H. (1974). The treatment of headache by means of electroencephalographic biofeedback. Headache, 13, 164–172.
Mueller, H. H., Donaldson, C. C. S., Nelson, D. V., & Layman, M. (2001). Treatment of fibromyalgia incorporating EEG-driven stimulation: A clinical outcomes study. Journal of Clinical Psychology, 57(7), 933–952.
Jensen, M. P., Grierson, C., Tracy-Smith, V., Bacigalupi, S. C., Othmer, S. (2007). Neurofeedback treatment for pain associated with complex regional pain syndrome. Journal of Neurotherapy, 11(1), 45–53.
Palm, U., Chalah, M. A., Padberg, F., Al-Ani, T., Abdellaoui, M., Sorel, M., … Ayache, S. S. (2016). Effects of transcranial random noise stimulation (tRNS) on affect, pain and attention in multiple sclerosis. Restorative Neurology and Neuroscience, 34(2), 189–199.
Pelletier, K. R., & Pepper, E. (1977). Developing a biofeedback model: Alpha EEG feedback as a means for pain control. International Journal of Clinical & Experimental Hypnosis, 25, 361–371.
Rosenfeld, J. P., Dowman, R., Heinricher, N., & Silvia, R. (1984). Operantly controlled somatosensory evoked potentials: Specific effects on pain processes. Chapter in B. Rockstroh, T. Elbert, W. Lutzenberger, & N. Birbaumer (Eds.), Self-Regulation of the Brain and Behavior. Proceedings of the Second International Symposium on Biofeedback and Self-Regulation, held May 15-19, 1983, at the University of Tübingen. Berlin: Springer-Verlag, pp. 164–179.
Rosenfeld, J. P., Silvia, R., Weitkunat, R., & Dowman, R. (1985). Operant control of human somatosensory evoked potentials alters experimental pain perception. Chapter in H. L. Fields, R. Dubner, & F. Cervero (Eds.), Advances in Pain Research and Therapy, Volume 9: Proceedings of the Fourth World Congress on Pain. New York: Raven Press, 343–349.
Schwedt, T. J., Schlaggar, B. L., Mar, S., Nolan, T., Coalson, R. S., Nardos, B., Benzinger, T., & Larson-Prior, L. J. (2013). Atypical resting-state functional connectivity of affective pain regions in chronic migraine. Headache, 53(5), 737–751.
Sime, A. (2004). Case study of trigeminal neuralgia using neurofeedback and peripheral biofeedback. Journal of Neurotherapy, 8(1), 59–71.
Siniatchkin, M., Hierundar, A., Kropp, P., Kuhnert, R., Gerber, W-D., & Stephani, U. (2000). Self-regulation of slow cortical potentials in children with migraine: An exploratory study. Applied Psychophysiology & Biofeedback, 25(1), 13–32.
Stokes, D. A., & Lappin, M. (2010) Neurofeedback and biofeedback with 37 migraineurs: a clinical outcome study. Behavioral and Brain Functions, 6(9)
Tansey, M. A. (1991). A neurobiological treatment for migraine: The response of four cases of migraine to EEG biofeedback training. Headache Quarterly: Current Treatment & Research, 90–96.
Walker, J.E. (2011) QEEG-Guided Neurofeedback for recurrent migraine headaches. Clinical EEG and Neuroscience, 42, 59-61.
Chronic Fatigue and Chronic Disease
Aparicio-Juárez, A., Duhne, M., Lara-González, E., Ávila-Cascajares, F., Calderón, V., Galarraga, E., & Bargas, J. (2019). Cortical stimulation relieves parkinsonian pathological activity in vitro. The European Journal of Neuroscience, 49(6), 834–848. https://doi.org/10.1111/ejn.13806
Barbault, A., Costa, F. P., Bottger, B., Munden, R. F., Bomholt, F., Kuster, N., & Pasche, B. (2009). Amplitude-modulated electromagnetic fields for the treatment of cancer: discovery of tumor-specific frequencies and assessment of a novel therapeutic approach. Journal of Experimental & Clinical Cancer Research: CR, 28, 51. https://doi.org/10.1186/1756-9966-28-51
Bilgin, H. M., Çelik, F., Gem, M., Akpolat, V., Yıldız, İ., Ekinci, A., … Tunik, S. (2017). Effects of local vibration and pulsed electromagnetic field on bone fracture: A comparative study. Bioelectromagnetics, 38(5), 339–348. https://doi.org/10.1002/bem.22043
Choi, M. C., Cheung, K. K., Zhang, Y., & Cheing, G. L. Y. (2015). Can pulsed electromagnetic field (PEMF) be a potential treatment for promoting angiogenesis in diabetic brain? Physiotherapy, 101, e247. https://doi.org/10.1016/j.physio.2015.03.427
Donaldson, C. C. S., Sella, G. E., & Mueller, H. H. (1998). Fibromyalgia: A retrospective study of 252 consecutive referrals. Canadian Journal of Clinical Medicine, 5 (6), 116127.
Guerriero, F., Botarelli, E., Mele, G., Polo, L., Zoncu, D., Renati, P., … Mannu, P. (2015a). Effectiveness of an Innovative Pulsed Electromagnetic Fields Stimulation in Healing of Untreatable Skin Ulcers in the Frail Elderly: Two Case Reports. Case Reports in Dermatological Medicine, 2015, 576580. https://doi.org/10.1155/2015/576580
Hamblin, M. R. (2017). Mechanisms and applications of the anti-inflammatory effects of photobiomodulation.” AIMS Biophysics, 4(3), 337–61. doi:10.3934/biophy.2017.3.337.
Hammond, D. C. (2001). Treatment of chronic fatigue with neurofeedback and self-hypnosis. NeuroRehabilitation, 16, 295–300.
Houreld, N. N., Sekhejane, P. R., & Abrahamse, H. (2010). Irradiation at 830 nm stimulates nitric oxide production and inhibits pro-inflammatory cytokines in diabetic wounded fibroblast cells. Lasers in Surgery and Medicine, 42(6), 494–502. https://doi.org/10.1002/lsm.20812
James, L. C., & Folen, R. A. (1996). EEG biofeedback as a treatment for chronic fatigue syndrome: A controlled case report. Behavioral Medicine, 22(2), 77–81.
Kayrian, S., Dursun, E., Ermutlu, N., Dursun, N., & Karamursel, S. (2007). Neurofeedback in fibromyalgia syndrome. The Journal of the Turkish Society of Algology, 19(3), 47–53.
Keczan, E., Keri, G., Banhegyi, G., & Stiller, I. (2016). Effect of pulsed electromagnetic fields on endoplasmic reticulum stress. Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society, 67(5), 769–775.
Knotkova, H. (2017). Adaptation of technology and protocol for remotely-supervised transcranial direct current stimulation (tDCS) in patients with complex symptoms due to serious chronic illness. Brain Stimulation, 10, 402. https://doi.org/10.1016/j.brs.2017.01.192
Kubat, N. J., Moffett, J., & Fray, L. M. (2015). Effect of pulsed electromagnetic field treatment on programmed resolution of inflammation pathway markers in human cells in culture. Journal of Inflammation Research, 8, 59–69. https://doi.org/10.2147/JIR.S78631
Li, J., Zeng, Z., Zhao, Y., Jing, D., Tang, C., Ding, Y., & Feng, X. (2017). Effects of low-intensity pulsed electromagnetic fields on bone microarchitecture, mechanical strength and bone turnover in type 2 diabetic db/db mice. Scientific Reports, 7(1), 10834. https://doi.org/10.1038/s41598-017-11090-7
Li, K., Ma, S., Li, Y., Ding, G., Teng, Z., Liu, J., … Guo, G. (2014). Effects of PEMF exposure at different pulses on osteogenesis of MC3T3-E1 cells. Archives of Oral Biology, 59(9), 921–927. https://doi.org/10.1016/j.archoralbio.2014.05.015
Mueller, H. H., Donaldson, C. C. S., Nelson, D. V., & Layman, M. (2001). Treatment of fibromyalgia incorporating EEG-driven stimulation: A clinical outcomes study. Journal of Clinical Psychology, 57(7), 933–952.
Neeb, L., Bayer, A., Bayer, K.-E., Farmer, A., Fiebach, J. B., Siegmund, B., & Volz, M. S. (2019). Transcranial direct current stimulation in inflammatory bowel disease patients modifies resting-state functional connectivity: A RCT. Brain Stimulation, 12(4), 978–980. https://doi.org/10.1016/j.brs.2019.03.001
Palm, U., Chalah, M. A., Padberg, F., Al-Ani, T., Abdellaoui, M., Sorel, M., … Ayache, S. S. (2016). Effects of transcranial random noise stimulation (tRNS) on affect, pain and attention in multiple sclerosis. Restorative Neurology and Neuroscience, 34(2), 189–199. https://doi.org/10.3233/RNN-150557
Pilla, A., Fitzsimmons, R., Muehsam, D., Wu, J., Rohde, C., & Casper, D. (2011). Electromagnetic fields as first messenger in biological signaling: Application to calmodulin-dependent signaling in tissue repair. Biochimica Et Biophysica Acta, 1810(12), 1236–1245. https://doi.org/10.1016/j.bbagen.2011.10.001
Ross, C. L., & Harrison, B. S. (2013). The use of magnetic field for the reduction of inflammation: A review of the history and therapeutic results. Alternative Therapies, 19, 8.
Shui, S., Wang, X., Chiang, J. Y., & Zheng, L. (2015). Far-infrared therapy for cardiovascular, autoimmune, and other chronic health problems: A systematic review. Experimental Biology and Medicine (Maywood, N.J.), 240(10), 1257–1265. https://doi.org/10.1177/1535370215573391
Tang, R., Xu, Y., Ma, F., Ren, J., Shen, S., Du, Y., … Wang, T. (2016). Extremely low frequency magnetic fields regulate differentiation of regulatory T cells: Potential role for ROS-mediated inhibition on AKT. Bioelectromagnetics, 37(2), 89–98. https://doi.org/10.1002/bem.21954
Tansey, M. A. (1993). Neurofeedback and chronic fatigue syndrome: New findings with respect to diagnosis and treatment. CFIDS Chronicle, 9, 30–32.
Tran, M. T. D., Skovbjerg, S., Arendt-Nielsen, L., Christensen, K. B., & Elberling, J. (2017). A randomised, placebo-controlled trial of transcranial pulsed electromagnetic fields in patients with multiple chemical sensitivity. Acta Neuropsychiatrica, 29(5), 267–277. https://doi.org/10.1017/neu.2016.51
Veronesi, F., Fini, M., Giavaresi, G., Ongaro, A., De Mattei, M., Pellati, A., … Tschon, M. (2015). Experimentally induced cartilage degeneration treated by pulsed electromagnetic field stimulation; an in vitro study on bovine cartilage. BMC Musculoskeletal Disorders, 16. https://doi.org/10.1186/s12891-015-0760-6
Zhou, J., Liao, Y., Zeng, Y., Xie, H., Fu, C., & Li, N. (2017). Effect of intervention initiation timing of pulsed electromagnetic field on ovariectomy-induced osteoporosis in rats. Bioelectromagnetics, 38(6), 456–465. https://doi.org/10.1002/bem.22059
Zhu, S., He, H., Zhang, C., Wang, H., Gao, C., Yu, X., & He, C. (2017). Effects of pulsed electromagnetic fields on postmenopausal osteoporosis. Bioelectromagnetics, 38(6), 406–424. https://doi.org/10.1002/bem.22065
Zinn, M. A., Zinn, M. L., Jason, L. A. (2017). Small-World Network Analysis of Cortical Connectviity in Chronic Fatigue Syndrome using Quantitative EEG. NeuroRegulation 4(3-4), 125-137.
