The mystery of the mysterious diseases

Migraine, fibromyalgia, are diseases whose origin and cure are unknown. That’s what they say.


Why it hurts so much and so often really is a mystery if what the doctors say is true: that there is nothing abnormal in the time, space and circumstance of pain.


- It shouldn’t hurt you.


It’s the same with pain and other perceptions.


- I’m hungry every day and every hour.


- You shouldn’t be hungry. You are well-nourished. Over-nourished, I would say...


It’s the mystery of why some citizens’ hunger increases when they eat, rather than diminish it.


- I’m more and more hungry. I don’t understand it. No food fixes it...


The brain is a perception manager. It projects hunger, pain, heat, cold, dizziness, fatigue, boredom, euphoria ... for reasons that we don’t always understand. If we have been several days without food it’s understandable that the brain reminds us, with hunger, that the body needs energy, but it doesn’t make sense for the brain to project the urge to eat on us if we are a little overweight.


The disease of chronic, unwarranted hunger is a mystery. The researchers track the chemistry of hunger in search of molecules that turn the need into a compulsive addiction. They always find one and make the media bells sound.


Those molecules are also found in that kind of pain.


The researchers are optimistic.


- In recent years there has been considerable progress in the understanding of pain. In the future we’ll have new drugs. Controlling the suffering won’t be a problem.


The problem of the future is that it’s never present in this issue.


The issue of hunger is not improving. Every day thousands of people die because of chronic insatiable hunger. The problem may even be getting worse.


The pain also wreaks havoc. Every day thousands of citizens die by chronic, insatiable consumption of analgesics. The problem may even go from bad to worse.


Reasonable, economic management of perceptual resources is not guaranteed. The brain doesn’t have a smart natural condition. Rather the opposite. It’s the individual’s job to channel the brain’s biological dynamics, selected for harsh and competitive environments, and adapt them to the universe of “everything is a hundred yards tall” and be safe.


There are children hunger and chronic pain, insatiable.


Some believe that everything is because of the inconsistency between what the alarmist genetics claims and what the culture of abundance offers. The human molecules of pain and hunger are the same as those of flies and worms in the laboratory. We should to track the differences between cultures.

- Culture, you say? Children have no culture, but they have migraine and fibromyalgia. It’s the genes and the undisclosed mysterious thing. There are entire families affected by this.

Curious and erroneous idea of culture. It seems that there can’t be cultural impregnation until we access the "use of reason".


The sapiens brain (ma non troppo) is, by what genetics dictate, candid, imitating and “schoolable”. It absorbs culture since the first hours of life.


Parents, teachers and friends are always around the child projecting words and examples, said and dones. The child's brain is a pasive schoolchild that takes everything that happens and hears in order to process it according to rules we don’t know about.


This week a patient came to my office with migraine, neck pain, rather chubby, moderately discouraged and she was a smoker. She did a good job of schooling in "my brain and it’s “I”" ... She no longer has migraines, her neck doesn’t hurt (there was also a great pedagogical work of two excellent "neurophysic therapists") she has earned a few anti-kilos, she is courageous after quitting the antidepressants she no longer absurdly inhales addictive toxic smoke..


She is an ideal patient, intelligent and hardworking.

For her there is no more mystery. It's all simple.

Saving the muscle

From the perspective of the pain always coming from wherever it’s felt and and hurting after  activity, we are tired without having made an effort, we sleep little and badly and we don’t recover energy nor muscle rest, it’s logical to conclude that widespread pain is a muscle-skeletal thing. The only thing left to do is feel the muscles to expose and objectify the corpus delicti. If we palpate muscles and get 11 painful points, the thing is clear: it’s fibromyalgia.

It’s the muscles. For the sufferers it’s clear. They don’t measure up. They are sore, bottomless, without energy, sensitive, inflamed. We must get them back with exercise but very gently, without excesses.

How did it all begin?

- In an accident, an idiot who hit us from behind on a red light.

- It was a time of a lot of stress ...

- The spine. Osteoarthritis ...

- It just happened ...

Experts seek and describe subtle chemical changes in muscles and nerve endings of nociceptors (vigilant neurons of harm). Something happens there. Wherever it hurts there is clear evidence of abnormality.

There is also evidence that the nervous system is hypersensitive. True, but this is due to the bombardment it’s submitted to from the center of muscle pain. It’s essential to identify and silence the nociceptive signal hideouts, hidden places from which the pain leaks and fills the neural network and keeps it at bay.

Massages, relaxations, gentle and progressive exercise, punctures on myofascial points, botulinum toxin, detachments, surgery ... Anything that puts out the muscle’s continuous fire will be beneficial.

Struggling with stress is necessary. No stress. Muscle contracture. No pain. Pain stresses. It’s prohibited.

Refreshing sleep is also needed. Insomnia is also prohibited.

The muscle must be treated with care. Non-toxic feeding. Healthy diet.

Positive attitude. Selflessness. Fortitude. Illness awareness. Hope. Optimism. Even pride if needed.

Drugs. Needles. Homeopathy. They don’t cure, but they relieve.

High spirits, even if the sky is falling. Don’t get depressed. Take antidepressants if needed.

It’s all about the muscle! It needs support, breath, be pampered.

Muscle fibers are hyperexcitable cells in their own right. If the environment is not adequate, they contracture creating vicious circles. If the task is not adequate, they suffer overload, abuse. There are "Cinderella" muscles. They’re the ones who deal with everything. The tasks of modernity aren’t the most appropriate. The computer... We don’t know why the sapiens’ (ma non troppo) cervicals are “pro-no”-ly selected for this damn modern life. What to say of the lumbar vertebrae! Why can’t we be quadrupeds! Bipedalism has given us an excessive bill. Free hands with an opponent thumb, yeah, that’s fine... but what about the back pain...?

There is an urge to protect the muscle since childhood. There are children with fibromyalgia. Muscularly healthy life. We already have the cardio-healthy proposals. The heart is also a muscle. Let’s do the same with the rest. Stretching. One hour before each game and one hour after. The kids need to acquire good habits.

There’s no doubt. The muscles are at their peak. We need them to be strong, energetic, relaxed...

- Brain, you say?

The brain decade has already passed. We are left with a lot of new and expensive drugs, social alarm for Alzheimer's and Parkinson's, promises ... and more suffering. More pain, more despair, more tiredness, more insomnia.

- Neurons? Are they cells?

When the embryo neurons first appear, they contact the muscle fibers and nothing will ever be the same for them. They will receive orders.

The muscle is a servant. Yes, the brain is the boss.

Fibromyalgia, a matter of muscle? A matter of brain?

Suit yourself...

Women and pain

Being a woman carries a higher risk of feeling pain, especially if pain is not associated with significant tissue damage.

In recent years, studies on differences in pain regarding gender have multiplied. This is a thorough review:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677686/pdf/nihms98634.pdf.

Why is there more pain among women?

Any proposals?

The first problem arises when we consider the origin of pain. Does the well or wrongly called "muscle-skeletal pain" come from muscles and the skeleton or from a vigilant-catastrophist brain advised by professionals who attribute too much responsibility to wear, bulges, pinches, contractures ...?

Is the female body more vulnerable, less resistant to mechanical stress?

Does the female body have more mechanical and psychoactive stress by the roles assigned by culture?

Is the feminine way of evaluating the source of pain more catastrophist?

Does the woman confront the problem by asking for more analgesic help?

What is the role of hormones?

How is feminine pain judged by professionals in comparison to masculine pain?

The questions could be multiplied to infinity through all the possible combinations of factors. The truth is that we have a serious problem of high incidence of local and widespread pain in women with the aggravation of the frequent company of a low mood and exhaustion.

The drama of fibromyalgia raises many questions about pain and gender. There are many works that seek (and find) the biological differences, influences of hormonal factors, different ways of brain processing. Biology exists. No doubt. But there is a lack of cultural considerations, the impact of learning by imitation-copy-empathy and expert information.

The organism is thoroughly analysed, its genes and hormones, its biography, its psychophysical stress. It’s the individual who catches a mysterious illness. The possibility of the organism being reasonably healthy but being managed by a brain that is wrong, although it may only be a hypothetical alternative of work and reflection, is not considered. If the pedagogy of pain can be reasonably improved, the female vulnerability may come, at least in part, from her biological and cultural condition for greater attention to avoid harm and to be guardians. The woman requests more diagnostical and therapeutical care, and therefore is more vulnerable to social expectations and beliefs, professionals, about injury and pain.

Fibromyalgia is the result of a sensitized brain. How does anyone get to sensitization? By the repetitive bombardment of signals of physical damage to an emotionally sensitive and depressive brain and in addition, or preferably, by indoctrination?

Do we need to update and spread information on neurobiology of pain? Are patients interested in such pedagogy or are they suspicious of it?

The female brain projects more pain on their heads, "muscles", "bones", "joints", "discs", abdomen, mouth. Real body? Virtual body?

Being a woman, hurts. That's the reality.

Illness behaviour

Imagine that you have caught the flu. Obviously, you feel sick. That means you want to stay in bed, you don’t want to eat or talk to relatives and friends and see everything a little darker than before falling ill. Youl also notice that you have a fever.

You will think that the symptoms are due to the flu virus causing you physical weakness and that feeling sick is only the expression of that weakness.

It’s a seemingly correct conclusion but, actually, what happens is something else. The whole picture of discomfort created by the infection can be reproduced by administering a molecule, the lipopolysaccharide, found in the capsule of a bacterium, that is, without causing any infection.

The symptoms of illness that forced you to behave as sick are generated by the turn on of a cerebral program known as cerebral disease response. In the presence of an infection, the affected (necrosated) tissues release, through immune system cells, messenger molecules (cytokines) to the brain and activate the program.

The same program can be activated in a healthy mouse if we apply these messengers (cytokines) of its sick partner to its brain. If a false message of illness arrives to the brain, it activates the corresponding program automatically. No matter how healthy the mouse is, it will feel sick and behave as such.

Imagine a society of mice with doctor mice that evaluate the symptoms and make analysis and X-rays. The healthy mouse with the unnecessarily activated program would tell its symptoms: "I'm tired, everything hurts, I’m not hungry, I want to stay at home, my mind feels so dense ...". All the analysis results would be normal and the doctor mouse would conclude: "everything is normal, I can’t find anything that’s wrong...", to which the healthy mouse with the active disease program would answer: “well, I feel awful, I must have something...". "I don’t I make up the symptoms."

The program of being sick is also activated in the baby mice if their mother abandons them and, as you may have noticed already, its expression corresponds to what someone feels when he or she is depressed or has fibromyalgia.

The brain contains multiple programs to produce the full range of comfort and discomfort perceptions.

If, for example, the brain turns the hunger program on, you feel like if you haven’t eaten in several days, but it hasn’t been more than two hours since you ate the snack and you are a bit overweight.

When the brain decides to activate disease programs is in order to make us act as if we were sick, even though we aren’t.

Why does it act like this? What is the point of feeling sick if we are not?

The brain is a hypotheses builder. It anticipates the events hastily. If fear of disease reaches the alert level, it’s not required to produce the disease so we feel ill. The fact that the program was activated is enough.

Disease symptoms are not caused by weakness, but by "illness behavior”, the program that encourages us, through the symptoms, to behave as sick.

The brain is not infallible. It overestimates danger and that can cause us many problems. One of them is feeling sick when we are healthy.

- I've been to the doctor’s office to see the analysis results. He told me that everything is normal and that what I have is psychological ... 

Evaluative disfunction as a risk factor

A reasonably healthy body managed by a mistaken, alarmist brain that maintains defensive programs needlessly is an abused body, subjected to physical burdens that undermine its integrity. Defense programs are justified when there is a noxious state or agent.

The program of preventive removal of the ingested (ie nausea to cause vomit) is biologically justified when we have eaten something dangerous, or when an animal stuffs itself with food and then regurgitates it to feed the brood or to hide food in a safe place. Activating vomit during a migraine attack or vertigo only produces discomfort, suffering and loss of energy (food). The body tends to activate preventively the nausea when it assesses internal problems. Germs and toxic substances go in through the digestive tract. If something goes wrong internally, the noxious agent might still be in the stomach, so the stomach-pumping program is turned on. Facial pain, toothache or muscle-skeletal system pain are not accompanied by nausea. The theoretically noxious is still at the entrance (mouth) or is a matter of mechanical stress (muscle-skeletal system). Biologically, vomiting does not make sense.

Keeping the hunger program on and eagerly promoting it despite overweight generates all kinds of physical inconvenience. Hunger is for when there isn’t any food available but can be found if one tries hard enough. It makes no sense if you have any extra kilos or if there is no chance of finding a tiny bite.

Managing the organism healthily involves being right in the decision to turn on and off and maintain programs, obtaining profit from it.

The erroneous assessment of relevant structural damage in the spine ("I have arthritis, pinches, hernias...") involves the turning on of defensive programs that cancel the articular function, contracture of inadequate muscles and increase of mechanical stress with each action. A spine with "wear" needs free joints, little mechanical load, freedom and promotion of movement, trust ... not fear of movement.

The erroneous assessment of disease activates the "sickness response" that promotes the  behavior of feeling "coming down with the flu” (sore, tired, unmotivated) not being sick. In the case of fibromyalgia, the brain maintains discouragement active (fatigue) and punishment (pain) of movement "as if" there was disease. Actually, the disease is generated by an erroneous evaluation of disease, the stubbornness in defending the idea that fibromyalgia is a disease (in the classical way) when the pathogenic state is the mismanagement of a healthy brain "as if" the individual was sick.

The stress program does its job: alerting the individual from an uncoded new incidence, measuring it, evaluating it, giving it relevance, selecting the coping resources and proceeding to activate the most appropriate behavior. After the event, shutting down the program. Stressing out is not working too hard, but doing it with a continuous assessment of shock, threat, catastrophism, subjection to an unknown hierarchy... being helpless...  

The program of feeling depressed makes sense when the reality at that moment is averse and doesn’t offer a solution until either circumstances have changed or a recent negative event has been sufficiently ruminated and digested. Continuous assessment of helplessness, low self-esteem or other’s, in the objective absence of weakness or adversity of the surroundings, cancels the motivational resources and condemns the individual to inaction.

The catastrophist assessment makes sense when there has been a negative factor and must be analyzed to learn how to avoid it or deal with it properly in the future. Once the analysis is done, the reflective period is turned off and the individual gets his or her act together to work towards his or her goals.

- Your brain doesn’t manage the programs properly. It evaluates the organism’s state wrongly. It sees danger, failure, vulnerability, illness, frailty. That’s why you have symptoms... that is, programs ... They are on and should be off.

- I disagree. I'm sick.

- If you think so, you’re feeding your brain’s erroneous evaluations, which is bad.

- I was told that my brain has lost volume in the cortex. That doesn’t seem normal to me.

- The connections between neurons are cheered up with action and turned off with discouragement. Your brain’s cortex has thinned because it has no stimuli. They are discouraged. Pleasure is requisitioned.

Confusing the appearance of disease with actual disease is not harmless. Not considering the brain’s evaluative error as a pathology that must be fought with the restoration of the health belief is a mistake. Defending and claiming the disease condition of a healthy organism is not harmless.

"... migraine, fibromyalgia ... are mysterious illnesses without treatment ..."

When will there be a serious, rigorous consideration of that omnipresent and overflowing category of diseases of cultural mediation?

It doesn’t look good...

I confess I have suffered

I had been suffering from back pain for a while, but this didn’t prevent me from continuing with my regular activities. A bad day when playing football, I was sure I had suffered from a herniated disc. I rested in bed, but it was getting worse and I eventually was advised to undergo surgery. So I did. I was extracted a large extruded disc. It all went well... for about 5 years. Then everything went from bad to worse with prolonged periods of taking for sick leaves, immobilized in bed. It has been about 20 years since then.

Body movement was very limited by pain and stiffness. Getting in and out of the car, sitting down, turning around or putting my socks on each morning was difficult and painful.

And so on for several years, taking sick leaves one or two months a year, confined to bed. The scanner showed postoperative changes, fibrosis and degenerative changes. The neurosurgeon took for granted that my column would be unstable and spoke of "installing some metals” ...

It was then when I discovered that my enemy was the rest and that movement would get me out of that situation. It was clear that any attempt to do something would activate pain on the spine. I thought there was a “pinched” nerve root, contractured muscles, arthritis, fibrosis ... enough conditions to justify the pain. I still had Descartes in mind and assumed that pain arose from where I was feeling it, from the spine.

Through simple movements in various positions and getting rid of fear, convincing myself that nothing bad would happen, each day I started regaining more and more mobility in the joints. At the same time, I gathered information about pain, depression, anxiety, neurophysiology... One question led me to another. Necrosis, apoptosis, inflammation, tissue repair, evolution, perception, efferent copy, reward systems, hypervigilance, mirror neurons, pain memory, nociception, culture.

I inadvertently changed my whole mindset. I stopped being Cartesian. I discovered that pain wasn’t coming from the spine, but from my brain. Each movement was evaluated and programmed by the brain. I would only express my desire to get up and my brain would do the rest. If my desire to turn, bend or stand up was rated as threatening, a defensive-deterrent program was activated. If the brain didn’t see it as a threat, it could achieve the purpose with a suitable, articulated program without hesitation.

At first I needed some kind of ritual. I would sit on a kitchen chair in hyperlordosis and stretch my head toward the ceiling as if it would make some nerve unpinch. Within seconds I felt the lower back had relaxed. Other times it was not enough and I had to lie down and make a series of moves to free the lumbar joints, hips ... Occasionally limitations of the past reappeared to a lesser degree: cramps, lashes, stiffness... I had to take extreme care to avoid flexing the spine when lifting weights, sitting straight forcing the lumbar curvature (lordosis) ... Some days were better, others worse, but I never took a sick leave again. Over the years everything has dissolved. I feel the way I want to feel, I lift weights without thinking about how I should be doing it, I have forgotten the "good postures" and I make a normal life with no restrictions.

Ten years ago I began to shape all these changes in my beliefs and knowledge and then it was time for action with those who suffered from migraine. Until then I used to tell them what I had been taught to tell (genes and triggers), prescribed what I had been taught to prescribe (antidepressants, beta blockers ...). When the triptans and anticonvulsants came by I was already a convicted infidel. I had replaced drugs with by talks, therapy with education. Then fibromyalgia and chronic fatigue syndrome (myalgic encephalitis) came by. I read an article by Simon Wessely on cognitive therapy and found the transcendence of information, beliefs and expectations and the angry reactions of the sufferer communities.

Later came the theory of information, signals, noise, processing, Bayes, neuronal networks.

Just a bit before publishing my first book, Jaqueca, análisis neurobiológico de un dolor irracional in 2004 (Headache, a neurobiological analysis of an irrational pain) I read an article by a man named Lorimer Moseley and, later, when I was into neurobiopedagogy, I read his book  Explain Pain. Moseley’s book freed me from feeling the burden of a preacher in the desert alone, and recently, the appearance of the SEFID (Spanish Society of Physiotherapy and Pain) made me feel a member of a group of therapists (including my daughter and my son-in-law) with lots of shared convictions, absolutely passionate about the biology of pain, tissues and neurons.

I had a really bad time during the "spine years”. There was no horizon. Only pain, numbness, fear, despair, inability ... The “brain years” have released me from that hell.

And here I am now, trying to show new beliefs to sufferers, with varying luck.

- I'm not convinced ... You say that pain does not exist ... that's in my mind ... it hurts because I think it'll hurt ... that it's psychological ... but I have been detected several herniated discs, arthritis, osteoporosis, grips by Resonances, my physiotherapist told me that I have many contractions, stress... I go to a back training school ...

From what is brought up, it’s believed and from what is believed, it’s created. At least that’s the way it is for lots of spine pain cases.

Children think, too

- As a kid I did not think in my head. But it hurt...

In absence of necrotic damage we consider that pain has a lot to do with learning. The brain learns to make mistakes, to unnecessarily activate the areas responsible for pain perception.

When leaving the doctor’s office, logically the sufferers will meditate about what they heard and their brain will present all kinds of objections in its tendency to uphold standards that have prevailed so far. A common objection is that of childhood.

"Kids do not think, but they feel pain, so they don’t feel pain due to their ability to think..." "I had pain as a child, so everything that this doctor is saying doesn’t really convince me..."

The child's brain thinks from the moment it starts existing, it processes all the huge amount of signals that arrive to its neurons to organize them, to attribute meaning, predict consequences of every action. All of this happens, at first, in the "womb", a protected place, presumably with no dangers and, therefore, no pain.

As soon as the creature leaves the womb to the extra-uterine world, uncertainties, risks, weaknesses, fears projected from an alarmist brain begin. The copying function of our neurons, the mirror function, reproduces motor patterns of what it sees, attributing emotional relevance.

Genetics imposes its law. The human brain is an imitator. It’s dictated by genes. The child's brain picks up what is happening around and builds programs influenced by outside events and copies the adults’ behaviours of response.

The anguish of the parents eases the anguish of their creatures. The use of painkillers is contagious.

- The child has migraine. It's genetic. It was inherited from you.

It makes no sense analyzing the effect of growing up exclusively by genes. If there is a time when there is somatic fear and dependence on what caregivers do and say, it is childhood.

A biologically alarmist brain raised in an environment of caregivers which were indoctrinated in the sensitizing concepts and practices of contemporary culture on pain is likely to generate biologically unjustified switch-ons.

The brains of children make mistakes in their practices. It is essential that caregivers help them be correct, banishing the somatic fear, enhancing self-control and minimizing dependence on external therapeutic actions.

There are children with migraine, fibromyalgia, atopic dermatitis, irritable bowel syndrome, allergies ... that’s logical. The brain is learning.

- There are migraine and fibromyalgia in children... so...

It is concluded, in my opinion wrongly, that the presence of these sufferings in childhood is an argument that contradicts the thesis of those that defend the learned, cerebral origin and strengthens the thesis of the disease.

The brain is plastic, namely, vulnerable, especially in childhood. Let’s take care of the children's learning. Let’s be afraid to them cultivating biological fear, expressed through symptoms. Let’s not interpret them as evidence of disease when there is no evidence of it, but as a mistake of the process of learning.

If we promote the idea of illness and struggle to get an external solution, a therapeutic one, we will turn physiological errors of the child’s brain into horror. We will condemn our children to something worse than disease: unjustified suffering, limitless, irrational, misunderstood, hopeless, even despised.

Think. The child's brain thinks... copies.

Process to information

The metaphor of the brain as an information processor, in this computer era we live in, is inevitable.

- The brain is like a computer. It processes information.

There are sufferings (migraine, fibromyalgia) characterized by chronic or repetitive pain in which no alterations that explain properly the symptoms are found. The sufferer is given diagnostic labels, obscure hypotheses about its origin and insufficient relief remedies.

Experts have just found molecular alterations that suggest that something wrong happens in the neural network and use the metaphor.

- The brain processes information wrong. Turns banal stimuli into painful. Everything becomes pain.

If someone is interested in the information itself, in its quality, the experts say ...

- There is not much information. We should organize sensitization campaigns, explain clearly the obscurities of the problem.

- I inform you: migraine, fibromyalgia... are diseases with a mysterious origin, they have no cure ...

The sufferers feel relieved when they’re given a label, to later plunge into despair when they realize that the information condemns them to live in a body governed by a pathological brain, sick, making daily life a living hell.

- Your brain processes information wrong. It’s hyper-excitable, sensitive. Genes, emotions, stress... have made it that way.

The sufferers don’t ask about information. Neither do experts, of course. They are “the parents of the child”.

Perhaps some rambling mind could be skeptical about this.

- Couldn’t it be that the problem is in the information? I don’t know... Sorry, don’t misunderstand me... but couldn’t it be that the information is not... let’s say... good?

- Our information is scientific. From science, we know that we know nothing but we are identifying molecules that don’t measure up.

- It occurs to me that, well... thinking about computers... that brains have... viruses. A brain is like a computer, connected to a network in which information flows freely.

- Well... that happens in movies. In the real brain there are only molecules: serotonin, dopamine, norepinephrine, endorphins, endocannabinoids, glutamate, genes... of course, there are no chips or circuits. We are not robots.

- Should I confide then in your information as an expert?

- It is the best possible one.

Is the brain really the responsible one? Does it process badly the best possible information? Or maybe, this is just an idea... could it be that it processes excellently the worst possible information?

- Are you suggesting that we are the experts the problem? That we should be processed?

- It was just a hypothesis ...