Central sensitisation is a neurological phenomenon in which the central nervous system (the brain and spinal cord) becomes hypersensitive, amplifying and prolonging pain signals. It involves changes in the way the nervous system processes pain, leading to an increased sensitivity to stimuli that would not normally be perceived as painful. This heightened sensitivity can result in chronic pain conditions.
Key features of central sensitisation include:
Amplification of Pain Signals: The nervous system becomes more responsive to pain signals, and normal sensory input may be interpreted as painful.
Lowered Pain Threshold: People with central sensitisation often experience pain with stimuli that would not typically cause pain in others, such as light touch or mild pressure.
Spread of Pain: Pain may spread beyond the initial site of injury or inflammation, affecting larger areas of the body.
Increased Sensitivity to Multiple Types of Stimuli: In addition to heightened pain sensitivity, individuals with central sensitisation may become more sensitive to other sensory stimuli, such as light, sound, and temperature.
Conditions associated with central sensitisation include:
Fibromyalgia: A chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in specific areas of the body.
Chronic Fatigue Syndrome: In addition to persistent fatigue, individuals with chronic fatigue syndrome may experience pain and heightened sensitivity to sensory stimuli.
Irritable Bowel Syndrome (IBS): Some individuals with IBS may have alterations in pain processing, contributing to abdominal pain and discomfort.
Migraines: Central sensitisation is believed to play a role in the development and maintenance of migraines.
Certain Forms of Arthritis: Conditions like rheumatoid arthritis and osteoarthritis may involve central sensitisation, contributing to pain perception.
Causes and Mechanisms:
Persistent Pain or Injury: Prolonged exposure to pain or repeated injuries can contribute to the development of central sensitisation.
Genetic Factors: There may be a genetic predisposition.
Neurochemical Changes: Alterations in neurotransmitters, such as glutamate and substance P, play a role.
Neuroplasticity: Changes in the structure and function of neurons in response to persistent stimuli.
Treatment:
Management typically involves a multidisciplinary approach, which may include:
Medications: Certain medications, such as tricyclic antidepressants, anticonvulsants, and medications that modulate neurotransmitters, may be prescribed to help regulate pain signals.
Physical Therapy: Exercise and physical therapy can play a crucial role in improving mobility, reducing pain, and promoting overall well-being.
Cognitive-Behavioral Therapy (CBT): CBT can help individuals manage pain by addressing thoughts, feelings, and behaviors related to pain.
Mind-Body Techniques: Relaxation techniques, meditation, and mindfulness can be effective in reducing stress and improving pain management.
Evaluation and treatment by an experienced physiotherapist is recommended to best manage central sensitisation as part of a pain process.
