Here is what is actually happening.
If you have fibromyalgia you have almost certainly been told, in various ways and by various people, that it is in your head. Not always those exact words. Sometimes it arrives as a suggestion that stress might be a factor, or that anxiety could be amplifying things, or that your pain sensitivity is higher than normal as though that explains rather than describes what is happening. Sometimes it is just exhausting trying to explain what a bad day actually feels like.
In between all of those appointments you have been getting on with your life. The pain is always there. Not sometimes. Not on the bad days. Always. And one of the most exhausting things about fibromyalgia is not the pain itself, though that is exhausting enough, but the continuous invisible labour of existing inside it while the world around you operates as though you are fine.
It is not in your head. It is in your microglia.
What fibromyalgia actually is
Fibromyalgia is increasingly understood as a neuroimmune and neuroinflammatory condition rather than a purely muscular or psychological one. Think of your microglia, the brain’s resident immune cells, as the bouncers at a party. In a healthy nervous system they patrol calmly, clear up after themselves and only escalate when something genuinely warrants it. In fibromyalgia, PET imaging studies suggest those same bouncers are activated across multiple brain regions, on permanent high alert, treating even ordinary signals as cause for alarm. Pain arrives without an obvious injury to explain it. Fatigue sets in after tasks that should cost nothing. Brain fog arrives unbidden. Temperature, sound and cognitive demand all become overwhelming. The security team has decided the party is dangerous, and once they have decided that, everything that comes through the door gets treated as a threat.
This is a measurable neuroimmune picture, not a psychological one, and it disproportionately affects women. Oestrogen fluctuations across the menstrual cycle, through perimenopause and in the postpartum period directly influence microglial reactivity, which is why fibromyalgia symptoms so often worsen at hormonal transition points and why the arrival of perimenopause so frequently corresponds with a significant escalation in symptoms that had previously been manageable.
Why heat makes everything worse
The same sensitised nervous system that amplifies pain and fatigue also makes temperature signals harder to process and regulate. Research confirms that autonomic dysregulation is a feature of fibromyalgia, and heat exposure pushes an already dysregulated system further into sympathetic overdrive. Pain spikes, fatigue deepens, brain fog thickens and the body loses what little capacity it had to find its way back to baseline. A heatwave is like someone turning up the music, cranking the heating and letting twice as many people through the door in a venue where the bouncers are already overwhelmed.
Your nervous system is not failing. It is overly sensitised, and sensitised systems feel everything more. That is not a character flaw and it is not something to push through.
During a heatwave, timing activity for early morning or evening, cooling the neck and wrists, prioritising electrolytes alongside hydration and reducing every other inflammatory input you have control over all genuinely help. Anti-inflammatory foods, avoiding alcohol, keeping blood sugar stable and prioritising cool sleep all reduce the baseline inflammatory state that heat is pushing against.
What actually changes things
Each of the approaches I use in clinic reaches the fibromyalgia picture differently and none of them ask you to choose between them and your medical care.
Craniosacral therapy works with the craniosacral system and the fascial tissue that connects everything below it, addressing the chronic holding patterns that keep the neuroimmune system running in a state of high alert. The fascia hosts over 250 million nerve endings and functions as a primary sensory organ of the nervous system, holding the bracing patterns that both reflect and perpetuate the sensitised state. Craniosacral work reaches these patterns in ways that talking therapies and pharmaceutical approaches cannot, because it communicates in the language of the tissue itself.
Somatic fascia release works with the accumulated tension held in the connective tissue, discharging the bracing patterns that developed when the body learned, through experience or through inheritance, that constant readiness was necessary. For women with fibromyalgia this often means working with decades of held tension in the jaw, diaphragm and pelvic floor and the fascial lines connecting all three.
EFT tapping has specific evidence in this population. A randomised controlled trial demonstrated significant improvements in pain, anxiety and depression following EFT treatment, and early pilot work has found measurable shifts in the expression of stress and immune-related genes following tapping sessions. It gives something portable, available during a heat driven flare or a difficult day when the body needs a way to shift state quickly.
Nutritional support addresses the cellular terrain that the inflammatory picture depends on. Anti-inflammatory foods, omega-3 rich sources, blood sugar stability, fermented foods and the fibre that supports the microbiome all reduce the background inflammatory load. Magnesium specifically, consistently depleted in fibromyalgia populations, supports nervous system regulation, muscle relaxation and sleep quality simultaneously.
Bach Flower Remedies sit in a different category and I will always be honest about the evidence, which is limited. What I observe consistently across twenty years of clinical practice is that they offer something the research has not yet found a way to measure, the felt sense of emotional support and acknowledgement that sends a signal to a long-defended nervous system that it is safe to begin to soften.
If you have been managing fibromyalgia without a conversation that looked at the whole neuroinflammatory, autonomic and nervous system picture, that conversation is available in my clinic in Kinsale, at The Natural Clinic in Cork and online.
Book a first session at loulanatural.com/make-a-booking or send me a message and tell me what is going on.
Serve Your Cells
Frequently Asked Questions
What is fibromyalgia and is it a real condition?
Fibromyalgia is increasingly understood as a neuroimmune and neuroinflammatory condition involving microglial activation in the brain, elevated inflammatory markers and central sensitisation of the nervous system. It is measurable, specific and real. PET imaging studies have demonstrated widespread microglial activation in people with fibromyalgia, which helps explain the widespread pain, fatigue, brain fog and sensory sensitivity that characterise the condition.
Why does fibromyalgia affect women more than men?
Female microglia are more prone to pro-inflammatory activation than male microglia, and oestrogen directly influences the reactivity of the brain’s immune cells. This means hormonal fluctuations across the menstrual cycle, through perimenopause and in the postpartum period can directly worsen fibromyalgia symptoms. Women also carry a disproportionate stress and caregiving load, which further primes the HPA axis and the neuroimmune system toward a sensitised state.
Why does heat make fibromyalgia worse?
Fibromyalgia involves autonomic dysregulation, meaning the nervous system already has difficulty regulating internal states including temperature. Heat exposure shifts a healthy nervous system toward sympathetic dominance, and for someone whose autonomic system is already in sympathetic overdrive, that additional load pushes the system further into dysregulation. This amplifies pain, fatigue and brain fog in ways that are physiologically measurable rather than simply subjective.
Can naturopathic treatment help fibromyalgia?
Naturopathic approaches including craniosacral therapy, somatic fascia release, EFT tapping and nutritional support address the neuroinflammatory and autonomic terrain that fibromyalgia exists within. They do not cure the condition but can meaningfully reduce the frequency and severity of flares, improve the nervous system’s capacity to regulate and address underlying drivers rather than only managing symptoms. They work alongside medical care rather than replacing it.
Is fibromyalgia connected to perimenopause?
Yes, and the connection is hormonal and neuroinflammatory. Oestrogen directly influences microglial reactivity, so the erratic oestrogen fluctuations of perimenopause can significantly worsen existing fibromyalgia symptoms or trigger a new escalation in women who have previously managed the condition. Many women notice a marked worsening of their fibromyalgia during perimenopause for exactly this reason.
What is the connection between fibromyalgia and the nervous system?
Fibromyalgia involves central sensitisation, where the nervous system amplifies and maintains pain signals long after any original injury has healed, and autonomic dysregulation, where the body’s capacity to regulate internal states is compromised. Both are nervous system phenomena, which is why approaches that directly address nervous system regulation, rather than only managing pain symptoms, tend to produce more lasting results.