FIBROMYALGIA AND
CHRONIC PAIN
It’s all in your head
FIBROMYALGIA
• Doctors don't know what causes fibromyalgia,
but it most likely involves a variety of factors
working together. These may include:
– Genetics. Because fibromyalgia tends to run in
families, there may be certain genetic mutations that
may make you more susceptible to developing the
disorder.
– Infections. Some illnesses appear to trigger or
aggravate fibromyalgia.
– Physical or emotional trauma. Post-traumatic stress
disorder has been linked to fibromyalgia.
Sleep Disorders Always
Accompany Fibromyalgia
THE 5 STAGES OF SLEEP
THE 5 STAGES OF SLEEP
• Usually sleepers pass through five stages: 1, 2, 3,
4 and REM (rapid eye movement) sleep.
• These stages progress cyclically from 1 through
REM then begin again with stage 1.
• A complete sleep cycle takes an average of 90 to
110 minutes.
• The first sleep cycles each night have relatively
short REM sleeps and long periods of deep sleep
but later in the night, REM periods lengthen and
deep sleep time decreases.
STAGE 1
• Stage 1 is light sleep where you drift in and out of
sleep and can be awakened easily.
• This is considered a transition period between
wakefulness and sleep. If you awaken someone
in the stage, they might report that they weren't
really asleep.
• During this stage, many people experience
sudden muscle contractions preceded by a
sensation of falling.
STAGE 2
• Stage 2 is the second stage of sleep and lasts for
approximately 20 minutes.
• Eye movement stops and brain waves become
slower with only an occasional burst of rapid brain
waves.
• Body temperature starts to decrease and heart
rate begins to slow.
STAGE 3
• Deep, slow brain waves known as delta waves
begin to emerge during stage 3 sleep.
• Stage 3 is a transitional period between light
sleep and a very deep sleep.
STAGE 4
• Stage 4 is sometimes referred to as delta sleep
because of the slow brain waves known as
DELTA WAVES that occur during this time.
• Stage 4 is a deep sleep that lasts for
approximately 30 minutes.
REM STAGE OF SLEEP
• In the REM period, breathing becomes more
rapid, irregular and shallow, eyes jerk rapidly and
limb muscles are temporarily paralyzed.
• Brain waves during this stage increase to levels
experienced when a person is awake. Also, heart
rate increases, blood pressure rises, and the
body loses some of the ability to regulate its
temperature.
REM STAGE OF SLEEP
• This is the time when most dreams occur, and, if
awoken during REM sleep, a person can
remember the dreams.
• Most people experience three to five intervals of
REM sleep each night.
DELTA SLEEP
• Stages 3 and 4 are referred to as deep sleep or
delta sleep, and it is very difficult to wake
someone from them.
• In deep sleep, there is no eye movement or
muscle activity.
• This is when some children experience
bedwetting, sleepwalking or night terrors.
DELTA SLEEP
• Delta Sleep is associated with:
– The production and release of Growth Hormone
necessary for tissue repair
– The production and release of Serotonin which is a
neurotransmitter necessary for reducing a persons
perception of pain
FIBROMYALGIA:
Linked to Sleep Disorders
• In 1975, two Canadian physicians and
researchers, Harvey Moldofsky, MD, and Hugh
Smythe, MD suspected sleep disorders as a
factor in Fibromyalgia.
• They conducted sleep studies to prove their
theory
FIBROMYALGIA: Sleep Disorders
• Using an EEG they measured the brain waves of
fibromyalgia patients when they slept
• The EEG can demonstrate when a person moves
in and out of Delta sleep
• In the study it was found that the patients with
Fibromyalgia were unable to go into Stage 4
sleep
FIBROMYALGIA: Sleep Disorders
• Another one of their studies involved awakening
healthy people and disrupting their sleep pattern
as they entered Delta sleep.
• They found that the healthy subjects developed
fibromyalgia symptoms when their sleep was
disturbed, but the symptoms subsided when they
were permitted to sleep undisturbed.
FIBROMYALGIA: Sleep Disorders
• They concluded that many of the symptoms
associated with fibromyalgia were related to the
disrupted sleeping patterns and the inability to
enter deep sleep
Muscle Abnormalities Linked
to Fibromyalgia
FIBROMYALGIA:
Muscle Abnormalities
• As we go through the coarse of the day our
muscles are constantly experiencing micro
traumas.
• Walking, bending, sitting still for too long creates
muscle damage which is repaired each night
when we sleep
• Growth hormone which is important in muscle
maintenance and repair, is secreted during Delta
Sleep
Muscle Abnormalities of Fibromyalgia
are Linked to Sleep Disorders
• Robert Bennett, MD, analyzed the connection
between sleep disorders and muscle damage.
• The research of Dr. Bennett indicates that most
fibromyalgia patients have a growth hormone
deficiency due to the inability to enter Delta Sleep
• Recall that Growth Hormone is produced and
secreted during Delta Sleep
Muscle Abnormalities of Fibromyalgia
are Linked to Sleep Disorders
• Low levels of Growth Hormone due to the inability
to enter Delta Sleep results in an inability to repair
the micro traumas that occur to the muscles each
day
• This effect is cumulative resulting in the muscle
abnormalities and disorders typically observed in
Fibromyalgia
• These abnormalities and disorders are a primary
source of pain
Muscle Abnormalities of Fibromyalgia
are Linked to Sleep Disorders
• According to this research, the primary goal in
addressing the muscle pain of Fibromyalgia
should be to re-establish proper sleeping patterns
that allow the patient to enter Delta Sleep
Fibromyalgia and Pain
Perception
FIBROMYALGIA:
Pain Perception
• Pain signals are generated by tissue damage in
the body
• The muscle damage of Fibromyalgia creates
electrical signals that are transmitted to the brain
and perceived as pain
• The more of these electrical signals that make it to
the brain, the more painful the experience
FIBROMYALGIA:
Pain Perception
• The human nervous system can modify these
electrical signals reducing the number of these
signals that make it to the brain.
• This modification of the signal reduces the
patient’s perception of pain
• This is why some people are more tolerant of pain
than others
FIBROMYALGIA:
Pain Perception
• In order for the nervous system to do this it needs
a neurotransmitter known as Serotonin
• Serotonin reduces the intensity of pain signals in
the nervous system.
• Serotonin is related to Delta sleep
• As a person goes into Delta sleep, serotonin is
released in the nervous system
FIBROMYALGIA:
Pain Perception
• If a person is unable to enter Delta Sleep their
levels of Serotonin are reduced resulting in an
inability to reduce the pain signals and a
heightened perception of pain
• The disrupted sleeping patterns of a Fibromyalgia
patient may result in low levels of Serotonin and
may explain why these patients seem to be in
constant pain
FIBROMYALGIA
Tying it all togerther
TYING IT ALL TOGETHER
• Sleep studies have demonstrated that people
suffering with Fibromyalgia are unable to enter
Delta Sleep
• Delta Sleep is responsible for the production of:
– Human Growth Hormone; and
– Serotonin
• Therefore, the sleep disorders associated with
Fibromyalgia result in decreased levels of these
substances
TYING IT ALL TOGETHER
• Human Growth Hormone is responsible for
repairing the tissues of the body damaged by
micro traumas associated with daily activity
• Without Human Growth Hormone these micro
traumas go unrepaired resulting in muscle
abnormalities and disorders commonly
associated with Fibromyalgia
• These muscle disorders are a primary source of
pain
TYING IT ALL TOGETHER
• Serotonin is a neurotransmitter produced during
Delta sleep and responsible for reducing a
patient’s perception of pain
• Low levels of Serotonin caused by the inability to
enter Delta Sleep cause a heightened perception
of pain such as what we see with Fibromyalgia
TREATING FIBROMYALGIA
The primary goal in the
treatment of Fibromyalgia is
to normalize sleeping
patterns allowing the patient
to enter Delta Sleep
INSOMNIA
AND
NEUROFEEDBACK
What is Neurofeedback Used For?
Over 40 years of peer reviewed, university
based research has demonstrated the
efficacy of neurofeedback in addressing
many neurological conditions
ADHD
Anxiety
Panic Attacks
Insomnia
Chronic Pain
Bedwetting
Migraine
Fibromyalgia
TBI
Tension Headache
PTSD
Depression
Learning Disorders
Autism / Asperger’s
Tics
As well as other conditions
TREATING INSOMNIA WITH
NEUROFEEDBACK
• A number of quality studies have been published that
show the effectiveness of neurofeedback in not only
easing the withdrawal symptoms of sleeping pills, but also
normalizing a patients sleep patterns without the use of
any medications at all.
• Neurofeedback research is based upon the principle that
insomnia Is connected with what is called hyper-arousal
within the brain and central nervous system. This hyperarousal is bio-electrical, or brainwave based in nature
INSOMNIA AND
NEUROFEEDBACK
• Mental states are associated with specific brainwaves
• Each bo known as arousal l
• These brainwaves include:
–
–
–
–
Delta
Theta
Alpha
Beta
INSOMNIA AND
NEUROFEEDBACK
• Delta and Theta represent the slowest processing
speeds and are associated with a twilight state
• Alpha represents a slightly faster processing speed and
is associated with quiet wakefulness such as when you
meditate
• Beta represents the fastest processing speed and is
associated with external focus, thought and
concentration
THE AROUSAL SPECTRUM
A healthy, regulated brain is able to shift easily between
arousal states as the demands arise
LOW AROUSAL
SLOWER
PROCESSING
Delta and Theta
IDLE STATE OF
THE BRAIN
Alpha
HIGH AROUSAL
FASTER
PROCESSING
Beta
OPTIMAL ZONE OF PERFORMANCE
The Brain has an optimal zone of performance
LOW AROUSAL
SLOWER
PROCESSING
IDLE STATE OF
THE BRAIN
HIGH AROUSAL
FASTER
PROCESSING
Depending on the circumstances and everyday demands, the brain
may move toward low arousal or high arousal but a well regulated
brain stays within its optimal zone of performance
THE DYSREGULATED BRAIN
UNDER-AROUSED
INHIBITED
OVER-AROUSED
• A dysregulated brain has a tendency to
habitually operate from one of the 3
arousal states
THE DYSREGULATED BRAIN
An individual’s habitual arousal state might be too high or
too low to support optimal function
UNDER-AROUSED
Impulsive
Socially
Inappropriate
Hyper-active
Easily Distracted
Excessive Speech
Disorganized
Hyper-emotional
INHIBITED
Victim Mentality
Excessive Self Concern
Rumination
Anger
Self Deprecation
Agitation
Irritability
Passive Aggressive
OVER-AROUSED
Excessive Rationalization
Poor Emotional Self
Awareness
Worry
Hyper-vigilant
Obsessive Thinking
Dislike of Change
Restless
THE DYSREGULATED BRAIN
An individual’s habitual arousal state might be too high or
too low to support optimal function
UNDER-AROUSED
Excessive
Delta and Theta
These patients usually
present with cognitive
impairment, focus and
attention issues,
ADHD, TBI, dementia,
learning disorders
INHIBITED
Elevated Alpha
These patients usually
present with symptoms of
depression, irritability,
lethargy, fibromyalgia,
metabolic issues
OVER-AROUSED
Elevated Beta
These patients usually
present with anxiety, panic
attacks, OCD, worry,
migraine, tension
headache, chronic pain,
insomnia
NEUROLOGICAL
DYSREGULATION
• Brainwave Imbalance or Neurological
Dysregulation may be caused by:
– Variations in brain structure
– Drugs
– Toxins
– Poor Nutrition
– Subluxation
– Trauma
– Stress – both physical and emotional
BRAINCORE THERAPY
Painless
Drugless
Non-Invasive
And Has No Side Effects
How is it Done?
All neurofeedback begins by performing a
Brain Map
The BrainCore Brain Map
A Brain Map provides us with the information
that is required to perform neurofeedback
training
THE BRAINCORE BRAIN MAP REPORT
The BrainCore Brain
Mapping software
analyzes thousands of
different variables and
compares your patient’s
brain map with a
database of normal
brain maps to produce a
the Brain Map report
THE BRAINCORE BRAIN MAP REPORT
The BrainCore Brain
Map Report provides
the neurofeedback
protocols that will be
used during the
neurofeedback
training
HOW IS NEUROFEEDBACK DONE
Individuals are hooked up to a computer using
wires and sensors and the computer reads
their brainwaves
Information about these brainwaves is
displayed on the doctors monitor
The software automatically detects when the
brainwaves are properly ordered and it feeds
that information back to the patient
This feedback appears in the form of a game,
movie, or sound which signals the patient that
the brainwaves are becoming more ordered
Rollercoaster Video
DVD’s and Movies
THE BIG IDEA:
When you have
information on what
your brain waves are
doing, your brain can use
that information to
change how it works.
54
Learning Is Permanent
• Once we learn
something it becomes
a permanent part of
our behavior.
• Follow up studies in
neurofeedback show
that the effects
continue for up to 30
years.
How Long Does it Take to Get Results?
•
•
•
•
Trainees typically come for 20 sessions of training.
Trainees come twice a week or more.
Each session is 30-45 minutes long.
They typically begin to see changes in about 5 to 8 sessions
NEUROFEEDBACK IS
BASED IN OVER 40
YEARS OF CLINICAL
RESEARCH PROVING IT’S
EFFICACY
In fact, Dr Frank H. Duffy, a Professor and
Pediatric Neurologist at Harvard
Medical School, stated that
“Neurofeedback should play a major therapeutic
role in many difficult areas. In my opinion, if any
medication had demonstrated such a wide
spectrum of efficacy it would be universally
accepted and widely used”
BRAINCORE THERAPY
QUESTIONS
A GIFT