FND and Chronic Pain
While FND is primarily a disorder of movement and sensation, Pain is one of the most common "invisible" symptoms. Up to 80% of people with FND report significant chronic pain, which can complicate recovery and impact mobility.
Central Sensitization
The brain's "volume control" for pain becomes stuck at a high level. Normal sensations are interpreted as painful by an over-active nervous system.
Chronic Fatigue
A bone-deep exhaustion that isn't cured by sleep. It often follows a "boom and bust" cycle where activity leads to many days of recovery.
The Vicious Cycle
Pain and FND symptoms often feed into each other. Pain causes the brain to focus more on the body (hyper-vigilance), which in turn makes motor symptoms like tremors or weakness more likely to occur.
Pain does not equal Damage
Managing Fatigue
The Pacing Protocol
Instead of pushing through fatigue, patients are taught "pacing"—doing a set amount of activity every day, regardless of how they feel, to slowly expand their energy limits without triggering a "bust."
Can Pain Improve?
Yes. As the brain becomes less "threatened" by its own sensations through education and graded movement, the central sensitization can decrease, and the "volume" of pain can be turned down over time.