Abstract

Fibromyalgia (FM) is characterized by widespread pain and multiple other symptoms; underlying mechanisms include central sensitization, dysregulation of the stress response system, and autonomic nervous system dysregulation. Alterations in the sympathetic nervous system have been variably implicated, but a reduction in parasympathetic nervous system (PNS) activity is now becoming more clearly implicated. Qigong, a traditional health and wellness practice that is also considered as mindful exercise or meditative movement, has been shown in several controlled and uncontrolled trials to be of marked benefit in FM, with effects that are sustained over time. Several hypotheses have been considered to account for the benefits of qigong practice, including autonomic regulation. The current article proposes that qigong, as a self-practice, leads to enhanced PNS activity, and this underlies benefits in FM and contributes to other health benefits that occur with extended practice. This hypothesis could be tested: (a) by exploring benefits of non-invasive vagal nerve stimulation (this should mimic effects of qigong), (b) by demonstrating that qigong practice produces changes in PNS activity, (c) by demonstrating that other non-pharmacological therapies that have been shown to be of benefit in FM also modulate PNS activity. The hypothesis is amenable to direct testing.