Functional neurological disorder (FND) affects how the brain and body communicate.[1] It can show up as weakness, tremor, changes in sensation, walking difficulties, or seizure-like episodes.[1] These symptoms are real and involuntary.[1]
A diagnosis can give you a name for what is happening while leaving you with practical questions. Why can a movement feel different from one moment to the next? How does pain fit into the picture? What kind of support should you look for?
This guide explains FND and its overlap with chronic pain, then describes the educational wellness sessions we offer at Go Pain to Power in San Antonio and remotely by Zoom.
What is functional neurological disorder?
The National Institute of Neurological Disorders and Stroke describes FND, also called functional neurologic disorder, as a condition involving changes in how brain networks work rather than structural changes that explain the symptoms.[1] A person is not choosing or deliberately producing those symptoms.[1]
The word functional refers to how the nervous system is functioning.[2] A normal-looking scan does not make a person’s difficulty walking, speaking, or using an arm less real.[1][2] It also does not establish an FND diagnosis on its own.[1][2]
FND is a specific neurological condition, rather than a general name for feeling stressed, overwhelmed, or disconnected from your body.[1][2]
What functional neurological symptoms can look like
People can experience different combinations of symptoms. Examples include:[1][2]
- An arm or leg feeling weak, heavy, or difficult to control.
- Tremor, jerking, muscle spasms, or changes in walking and balance.
- Numbness, altered sensation, or visual symptoms.
- Difficulties with speech, swallowing, concentration, or memory.
- Functional or dissociative seizures, which can resemble epileptic seizures but have a different mechanism.
These experiences can overlap with other neurological conditions, and FND can coexist with another diagnosis.[1][2] The pattern and clinical examination matter more than matching yourself to a symptom list.[1][2]
How FND is diagnosed: positive signs, not just normal scans
An FND diagnosis is based on recognizable clinical features, often called positive signs.[2] A specialist looks for particular patterns in how symptoms appear or change during an examination.[1][2] NHS inform specifically notes that a diagnosis should not be made only because scans or tests for other conditions are normal.[2]
Examples include Hoover’s sign when assessing functional leg weakness and entrainment when assessing a tremor.[1] These are clinical findings interpreted as part of a neurological assessment.[1]
If you have received an FND diagnosis, it is reasonable to ask: “Which findings supported the diagnosis in my case?” A clear explanation gives you something more useful than being told that the tests did not find damage.
The movement comparisons described in our private-session process below serve a different purpose: they let you describe your response during a wellness session. They are not the diagnostic examination discussed here.
FND and chronic pain
Chronic pain can occur alongside FND.[3] A 2024 systematic review in the Journal of Neurology, Neurosurgery & Psychiatry estimated that 55% of people with FND in the pooled cohorts reported pain.[3] That estimate came from 30 cohorts involving 4,272 people, with a 95% confidence interval of 46% to 64%.[3]
The review also found that pain often persisted even when other FND symptoms improved with treatment.[3] Its authors argued that pain should be considered directly in assessment, care, and outcome measurement.[3]
For someone living with both, that means the conversation should include the pain itself: where it occurs, how it affects sleep or activity, and what has helped. An FND diagnosis does not make pain unimportant, and pain alone does not establish FND.
Our guide to chronic pain, stress, and the nervous system explores the broader pain conversation. The overlap is a reason to ask more specific questions, not to assume that every symptom has the same cause.
Is FND caused by stress?
Stress can be relevant for some people, but it is not a universal explanation.[1] NINDS notes that psychological stressors and childhood adversity are risk factors that are not present in everyone with FND.[1]
A useful conversation can include injury, illness, sleep, pain, current demands, and emotional experiences without forcing a single story onto every person. You do not have to identify one traumatic event to make your symptoms legitimate.
Can FND improve?
Improvement is possible.[2] NHS inform explains that some people benefit substantially from treatment and may experience remission, while others continue to have symptoms.[2] The care plan depends on the person’s symptoms and needs.[2]
Established FND care can involve a coordinated team.[1][2] Specialized physical therapy may address movement symptoms; occupational therapy can help with daily activities; speech and language therapy can address communication or swallowing difficulties.[1][2] Psychological therapy can also help, including for some people who do not identify stress as a major issue.[2] It is not required for everyone.[1][2]
The practical goal is to find care that understands your symptoms and can explain what you will work on together. Ask how progress will be assessed and how pain or fatigue will be addressed if those are part of your experience.
Finding FND support in San Antonio
If you are looking for FND support in San Antonio, distinguish between help understanding the diagnosis, FND-informed rehabilitation, and support with everyday comfort and activity. A neurologist or the clinician coordinating your care can help identify the clinical services relevant to your symptoms.[1][2]
Before choosing a provider, useful questions include:
- Do you work with people who have my particular symptoms?
- What would we work on during an appointment?
- How will we compare progress in daily life?
- How does this fit with the care I already receive?
At Go Pain to Power, our offering is a private educational wellness session. The next section describes that process so you can decide whether you want to explore it alongside your existing care.
What happens in a Go Pain to Power session?
I start with something concrete that matters to you, rather than assuming everyone with the same diagnosis needs the same input. You might want to discuss discomfort when turning your head, the effort of standing, or a movement that feels restricted.
- Choose a comfortable starting check. Describe the movement or function and what you notice. Mention current care and any restrictions before you begin.
- Explore a gentle sensory input. Depending on the session, that may involve movement, touch-based work, or another sensory input. Your feedback helps set the pace.
- Repeat the same check. Compare the movement, effort, or sensation. Describe what changed and what did not.
You can ask questions, pause, or choose a different starting point. You do not need to push through an uncomfortable movement. Read how sessions work for a fuller walkthrough.
Private sessions last approximately one hour. A first visit is $350 and a return visit is $175. In-person appointments take place at 3503 Paesanos Pkwy, Suite 201, in Shavano Park, serving the San Antonio area. Remote sessions are available by Zoom; you follow guided steps from home and describe what you notice.
You can review appointment options and book a private session, or read the location and remote-session details.
Sources
[1] NINDS: Functional Neurologic Disorder
