This is the 4th blog post from The Embodied Mind series by Dr Alice Siberry.
As understanding of neurodiversity grows, much of the conversation still focuses on cognition, how people think, communicate and process information. Yet some of the most impactful differences quietly shaping daily life remain largely unseen.
Pain, fatigue, movement differences and physical instability often sit in the background, rarely discussed and frequently misunderstood. For many neurodivergent people, these bodily experiences shape everything from posture and energy levels to emotional wellbeing and participation in work, education and relationships.
Neurodivergence and connective tissue: an emerging link
Research is increasingly highlighting the association between neurodivergent conditions such as autism and ADHD, and connective tissue disorders including hypermobility spectrum disorders and hypermobile Ehlers-Danlos syndrome (hEDS).
These conditions affect:
- Joint stability and movement
- Skin elasticity
- Autonomic nervous system regulation
Common experiences include joint pain, dislocations, fatigue and chronic pain.
Large-scale studies show that autistic people are significantly more likely to be hypermobile than non-autistic people, and that hypermobile individuals are more likely to be autistic (Baeza-Velasco et al., 2025). Data from the hEDS-START study (Crompton et al., 2025) also found that autistic participants reported higher rates of hypermobility-related symptoms and co-occurring mental, neurological and physical health conditions.
These overlaps suggest shared mechanisms involving collagen production differences, sensory processing challenges, immune functioning and autonomic regulation, though research is still evolving in this area.
Research spotlight: Dr Jessica Eccles (“Dr Bendy Brain”)
Much of the emerging understanding of neurodivergence and embodied experience has been shaped by the work of Dr Jessica Eccles, often known as “Dr Bendy Brain”. Her research has been central to highlighting the overlap between neurodivergence, hypermobility, autonomic dysfunction, chronic pain and fatigue.
In an upcoming study conducted with Dr Eccles’ and the Brighton and Sussex Medical School found striking differences when comparing neurodivergent individuals to the general population:
- More than 50% of autistic participants, those with ADHD and those with tic disorders (including Tourette’s) showed elevated levels of hypermobility, compared with only about 20% of the general population.
- Neurodivergent participants also reported significantly more pain and symptoms of dysautonomia than their non-neurodivergent peers.
Dr Eccles’ work is helping move these experiences out of the realm of anecdote and into rigorous scientific inquiry, strengthening the case for understanding neurodivergence as a whole-body experience.
Proprioception: The body’s sixth sense
Proprioception, sometimes called the body’s sixth sense, allows us to sense where our limbs are, how much force we’re using, and how we move through space, without consciously thinking about it.
For neurodivergent people, proprioceptive experiences can vary widely:
- Reduced awareness, leading to perceived ‘clumsiness’, overexertion or injury
- Heightened awareness, where pressure or movement feels uncomfortable or overwhelming
- Differences in posture, muscle tone and coordination.
When proprioceptive feedback is inconsistent, the brain’s internal “map” of the body may not match lived experience. This mismatch can increase fatigue, pain and frustration, particularly during repetitive tasks or prolonged physical activity.
Consider a dyspraxic young adult learning to drive. Despite understanding the rules of the road and being able to describe each step verbally, coordinating their feet, hands, mirrors and spatial awareness simultaneously is exhausting. Judging how much pressure to apply to the pedals, how far to turn the wheel or where the edges of the car are in space doesn’t come automatically as it might for others. Each movement requires conscious effort.
What might look like “slow learning” is actually a nervous system working without reliable proprioceptive feedback. Over time, this constant compensation can lead to significant fatigue, anxiety and physical tension, long before a test is even attempted.
Pain, fatigue and interoception
Pain is not just a signal from the body; it is an experience shaped by interoception, our awareness of internal bodily states.
Neurodivergent people may experience:
- Heightened pain sensitivity due to sensory differences
- Reduced awareness of pain until it becomes severe
- Difficulty describing or localising pain
- Strong stress-pain interactions driven by autonomic responses.
Chronic muscle tension from masking, anxiety or prolonged sympathetic (“fight or flight”) activation can further amplify discomfort.
Take this example: an autistic person accidentally touches the blade of a rotating blender. They calmly switch the blender off and begin cleaning and dressing their deeply cut hand, seemingly unfazed. Only after several moments does the body override the brain, and they start to feel dizzy. Shortly afterwards, they faint.
This isn’t bravery or shock tolerance. It’s delayed interoceptive signally. The body registers the injury, but the conscious awareness of pain, blood loss and physiological stress arrives later, and all at once. Experiences like this help explain why some neurodivergent people may appear unaffected by injury, or general pain, initially, only to become suddenly unwell later.
Understanding the interplay between proprioception, interoception and connective tissue differences is key to recognising why pain and fatigue may persist, even when outward signs appear over-exaggerated or even subtle.
The autonomic nervous system and dysautonomia
The nervous system includes both voluntary (central nervous system) and involuntary functions. Involuntary functions are regulated by the autonomic nervous system and includes processes such as heart rate, digestion, temperature and blood pressure.
When this system becomes dysregulated, an umbrella of potential conditions can arise, called dysautonomia. People may experience:
- Dizziness or fainting
- Rapid or irregular heartbeat
- Blood pressure changes
- Digestive issues
- Fatigue and brain fog
- Temperature regulation difficulties
- Sleep disruption.
Research suggests dysautonomia is more common in neurodivergent populations. Owens et al (2021) found that 20 out of 28 autistic participants had a diagnosed autonomic condition, with postural tachycardia syndrome (PoTS) particularly prevalent. Interestingly, most of those individuals also had Ehlers-Danlos syndrome.
These findings align with patterns explored earlier in this series: that neurodivergent bodies appear to spend prolonged time in sympathetic activation, with insufficient access to parasympathetic “rest and digest” states.
Inflammation, pain and chronic fatigue
Inflammation has become a recurring theme throughout the Embodied Mind series, suggesting that as well as insufficient access to parasympathetic functions, neurodivergent people appear to experience increased rates of inflammation. In support of this suggestion, studies show high rates of chronic pain in neurodivergent populations. For example:
- 66% of adolescents with ADHD report chronic pain
- 55% report musculoskeletal pain
- 31% experience multi-site pain (Battison, 2023)
Neuroinflammation (inflammation originating in the brain) within dopaminergic pathways may contribute to this increased rate (Kerekes, 2021). Dopamine and noradrenaline, often reduced in ADHD, plays a crucial role in pain modulation, potentially increasing vulnerability to feelings of and experiences of pain (Kasahara, 2025).
Fatigue is also increasingly recognised as a core issue. Quadt et al. (2024) found higher risk of chronic disabling fatigue in children with neurodivergent traits, which were likely attributed to inflammatory processes. This has gained renewed attention in the context of long COVID, where prolonged fatigue is common.
Evidence suggests dysregulated immune and inflammatory responses may form a mechanistic link between neurodivergence, chronic pain and fatigue, particularly following illness or prolonged stress.
When pain is missed or dismissed
Despite the existing and ongoing evidence, many neurodivergent people report:
- Misdiagnosis or delayed diagnosis of physical health conditions
- Pain attributed to “growing pains”, anxiety or other neurodivergent ‘behaviours’
- Difficulty being believed or referred for specialist support.
Interoceptive differences and communication barriers can make it hard to describe pain in expected ways. Over time, disbelief can become traumatic, compounding both physical and emotional distress.
This is despite awareness that physical health challenges have wide-reaching impacts:
- Increased absence from school or work
- Reduced participation and social isolation
- Cognitive strain affecting attention, memory and processing
- Emotional distress linked to unmanaged pain and/or fatigue.
Without a whole-body lens, these experiences are often misinterpreted as a lack of motivation or resilience.
Bringing the body into the conversation
This final blog brings the Embodied Mind series full circle.
Sleep, digestion, proprioception, interoception, pain and fatigue are not separate issues. They are interconnected and they shape how neurodivergent people experience the world.
When we acknowledge and recognise the role of the whole body, we move closer to a more accurate understanding of neurodivergence and neurodivergent experiences. One that recognises difference without dismissal and complexity without blame.
Because neurodiversity has never claimed to be just about the brain, it is about the whole person, the human body, including the brain.
How we support this in the workplace
For organisations, this understanding often raises important questions about how best to offer support in practice. Creating environments where neurodivergent people can be understood and supported well requires a multi-disciplinary approach. Through our Neurodiversity Line Manager Awareness Programme, coaching and wider neurodiversity training, alongside the Level 4 Neurodiversity Workplace Needs Assessor course, we work with managers and professionals who are seeking to deepen their understanding and develop thoughtful, sustainable approaches to support.
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References
Baeza-Velasco, C., Vergne, J., Poli, M., Kalisch, L., & Calati, R. (2025). Autism in the context of joint hypermobility, hypermobility spectrum disorders, and Ehlers–Danlos syndromes: A systematic review and prevalence meta-analyses. Autism, 29 (8), 1939-1958. DOI https://doi.org/10.1177/13623613251328059
Battison, E. A. J., Brown, P. C. M., Holley, A. L. and Wilson, A. C. (2023) Associations between Chronic Pain and Attention-Deficit Hyperactivity Disorder (ADHD) in Youth: A Scoping Review. Children (Basel), 10 (1). DOI: 10.3390/children10010142
Crompton, C.J., Efthimiou, T.N., Dockrell, D., & Berg, K., Health Experiences and Outcomes of Hypermobile Autistic and Non-autistic Adults (2025) Presentation at Autism Europe, Dublin, Ireland. (manuscript in prep).
Kasahara, S., Yoshimoto, T., Oka, H., Sato, N., Morita, T., Niwa, S., Uchida, K. and Matsudaira, K. (2025). Correlation between attention deficit/hyperactivity disorder and chronic pain: a survey of adults in Japan. Sci Rep 15. DOI: https://doi.org/10.1038/s41598-025-95864-4
Kerekes, N., Sanchéz-Pérez A. M., and Landry, M. (2021) Neuroinflammation as a possible link between attention-deficit/hyperactivity disorder (ADHD) and pain. Med Hypotheses. 157. DOI: 10.1016/j.mehy.2021.110717
Owens, A. P., Mathias, C. J., Iodice, V. (2021) Autonomic Dysfunction in Autism Spectrum Disorder. Front Integr Neurosci, 15. DOI: 10.3389/fnint.2021.787037 Quadt, L., Csecs, J., Bond, R., Harrison, N. A., Critchley, H. D., Davies, K. A. and Eccles, J. (2024) Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case-control study. Paediatrics, 14 (7). DOI: https://doi.org/10.1136/bmjopen-2024-084203