• How does the Somerset Community Pain Management Service support people who have Fibromyalgia

    Our approach is based on a theory called the Hyland Model. It was developed by Professor Michael Hyland. He has worked with the pain service in Plymouth to develop a treatment plan which he calls Body Reprogramming.

    We use this approach both in our individual work with people with Fibromyalgia and also in the course that we offer.

    You will find more information about the Hyland Model and Body Reprogramming below.

    What is Body Reprogramming? 

    Body Reprogramming is used to help people understand central sensitivity conditions like fibromyalgia and chronic fatigue syndrome (CFS) and understand how these can be treated.

    The aim is to help you to understand how your fibromyalgia may have developed, what factors may be worsening symptoms and learn strategies to help you recover.

    What is central sensitisation?

    Central sensitivity conditions occur when there are changes to the way the central nervous system (the brain, spinal cord and nerves) process information.

    Central sensitivity conditions are not dangerous but people can experience a wide range of symptoms.

    In central sensitisation syndromes such as fibromyalgia, the body’s natural protective systems have become overactive in a way which is unhelpful and makes everyday life painful and difficult.














    What is it like to live with fibromyalgia?

    Symptoms of fibromyalgia:

    Fibromyalgia is not ‘just’ pain symptoms. 
    All patients experience fatigue to a greater or lesser extent. 
    Data suggests that on average, people with fibromyalgia experience 35 symptoms a week (see diagram).

    The more severe the illness, the more symptoms there are and the more frequently the symptoms occur.
    People with central sensitivity syndromes, such as fibromyalgia often find that their symptoms vary over a period of time for no specific reason.
    Different activities and life events influence symptoms. These can make your symptoms worse or better depending on what it is and how your body responds. 
    Because of these varied symptoms people with fibromyalgia may have had multiple investigations finding little or no structural damage and may have more than one diagnosis related to central sensitisation.

    The Hyland model

    The body as a computer:

    According to the Hyland model, the body is like a very clever computer that sometimes experiences hardware and software problems. 

    The body’s hardware is the ‘physical’ parts of the body - such as eyes, legs, lungs and heart.

    The body’s software consists of instructions that are sent throughout the body to direct the hardware functions. Software problems do not show up on blood tests, scans and x-rays.

    The STOP programme:

    Fibromyalgia is caused by a faulty programme (or software problem) called ‘a STOP programme’. The stop program generates symptoms that stop or change the way you are doing things.

    As you can see from the diagram of the human body above, people with fibromyalgia experience a wide variety of symptoms.  These symptoms are all STOP signals as they STOP you from doing things. For example:

    Fatigue stops you doing too much
    Pain prevents you from damaging yourself
    Nausea stops you eating bad food

    It is important to note that stop signals keep you safe and so you need them. 

    However, if over a period of time, you fail to respond to your body’s stop signals, your body gradually adapts by changing its software so that the stop signals become stronger. Your body starts to ‘shout louder’. 

    Your shouting body can develop a ‘stop programme’. The stop program creates stop signals, even when the stop signals are not needed. The stop programme is unhelpful and stops you doing things you should be doing. 

    The stop program is a faulty programme that your body has developed, as a way of compensating for a particular pattern of lifestyle – a pattern of lifestyle where stop signals didn’t produce their intended effect.

    What causes the STOP programme?

    There are lots of different reasons why people, for no fault of their own, keep going and do not respond to stop signals. The reasons fall into three categories:

    People sometimes keep going even though what they are doing is difficult, tiring and even painful. This might be because they are caring for others, have lots of obligations or because they have set themselves high standards.
    People sometimes have to keep going because they are in a bad place and they can’t get away.
    People sometimes want to keep going because what they are doing is fun, exciting or successful.

    Using the Hyland model to promote recovery: 

    Reducing the effect of the STOP program is essential to recovery.
    The stop program is triggered by lifestyle; therefore, the cure is also through lifestyle. This is a slow and steady process.
    Most people with fibromyalgia experience fatigue, and so may think their body has run out of energy. But the body has not run out of energy, it has just put on the brakes. Doing too much will jam the brakes on harder and doing too little means the brakes simply remain on. You can’t get better by putting your foot on the accelerator and resting on its own won’t make you better either. To get better, you need to learn to gently take off the brakes. 

    There are three general rules for eliminating the STOP Programme: 

    Do things which don’t produce STOP signals: You need to be able to teach your body that your behaviour does not need to create STOP signals.
    Teach your body that the world is a good and safe place: When there is a STOP programme, the body interprets the world as a bad and dangerous place – and indeed this may at times have been the case for you. Pain when moving, is the body’s way of protecting you from that bad and dangerous world. You need to teach the body that the world is safe.
    Support your body’s software by improving the health of your body. The body’s software is spread throughout the body and the best way to support it is to make the whole body healthy. When you have a software problem it is very easy for the hardware (for example, the joints and muscles) to lose strength and fitness. This tends to increase pain. There are lots of ways of improving health, but you need to find the way that is right for you.

    If you would like to know more about the Hyland Model or our Body Reprogramming course we recommend you:

    • Look at the information and videos on the website at
    • Ask the health care professional that you are seeing at the pain service
  • Body Reprogramming Course: Patient Story

    “I've had a fluctuating time since being on your Body Reprogramming Course but I would like to say that the course is very accessible and user friendly. From a professional side it delivered information and tools in an understandable and positive manner . 

    I felt that the course was empowering in that it listened to each individual and recognised that everyone is different.  I also liked the collaborative element which was encouraged.  Being able to access the Body Reprogramming Course from your own home also has added benefits for anyone unable to travel . 

    The course facilitators were knowledgeable friendly and easy to engage with  and the course itself gave a different perspective , a more holistic view to managing my condition than that of a purely medical modal point.”

    LB (Patient)