Central Sensitisation
Over the last few months I have been explaining what central sensitisation is to a number of people. I thought that it would be useful for people to have a read through what it is slowly as it is prevalent in the chronic pain (3 months +) patient population and can be somewhat tricky to digest and understand.
Central sensitisation involves pain being modified by the way that the central nervous system (the brain and spinal cord) works so that sensitivity of the affected area increases. Central sensitisation can, but doesn't always, begin after 3 months or longer. One of the main differences between acute and chronic pain is central sensitisation. Whereas acute pain involves structural damage which resolves once it has healed, chronic pain can persist due to the changes in the central nervous system. Symptoms of central sensitisation vary but can can manifest in ways such as:
Pain being experienced with normal touch and pressure
Exaggerated pain responses to normally painful things
Pain taking longer to fade away after the initial stimulus
Pain is an extremely useful system as it warns us as to what we should and shouldn’t be doing. Therefore central sensation is an over-reaction to what the central nervous system perceives to be a danger. So you might now be asking well what do if I find myself in this situation? The answer is not necessarily simple but it does start with having a think about when doing certain movements/activities whether you are experiencing more pain than is to be expected. This can be tricky as the majority of us shy away from pain as when it hurts we shouldn’t do it!
Essentially the way central nervous sensitisation is addressed is through education as to why pain is being experienced and breaking what is known as the vicious physical and psychological cycle as shown below.
From http://www.backexperts.co.uk/
By understanding that there isn’t necessarily any injured tissue, rather it is the changes in the central nervous system, it leads to people confronting their pain through movement and asking themselves if discomfort that they are feeling is an over-reaction.
From http://www.physio-pedia.com/Psychological_approaches_to_pain_management
As always team I’m always happy to have a chat about it at the clinic so do feel free to ask if you have any questions.
Until next time!
Vincent Harvey
Physiotherapist