What Is Central Sensitization Syndrome?
So, you’ve been experiencing persistent symptoms of pain and fatigue, and perhaps even received one of the following diagnoses: chronic pain, chronic fatigue syndrome, chronic pain disorders. chronic pain syndrome, chronic widespread pain, or fibromyalgia. If this is the case and no direct physical cause has been identified, your symptoms may be due to Central Sensitization Syndrome. But what is Central Sensitization Syndrome? This article will discuss the symptomology, causes, and most importantly, how self-directed neuroplasticity may be able to help you.
Start here: What is Central Sensitization Syndrome or CSS?
Imagine for a moment your clothes rub against you or you accidentally brush against another person. Doesn’t sound like much, right? Now imagine that every time this happens you experience significant discomfort and maybe even pain. Individuals who experience central sensitization of the nervous system can experience this sensitivity on a daily basis. Central sensitization syndrome is caused by the amplification of neural signaling in the central nervous system (CNS), leading to pain hypersensitivity.
Research has shown that millions of people around the world are affected by central sensitization due to its involvement in many pain disorders. For example, central sensitization is implicated in the following conditions:
- Irritable Bowel Syndrome
- Temporomandibular Disorder
- Multiple Chemical Sensitivities
- Atypical Facial Pain
- Tension Headache
- Brain fog
- Widespread pain
Central sensitization is not a homogenous condition, and different individuals may have very different symptoms. For example, there may be variation in the degree to which pain is amplified and in which types of sensations elicit pain. Technically, the medical terms for these two types of symptoms are allodynia – the pain a person will feel from things that aren’t usually painful – and hyperalgesia, or perceiving something as more painful than it should be.
In general, the nervous system is in a heightened state of reactivity which can transform mild sensations into painful discomfort. Although this amplification can be overwhelming, and it may feel like there are no clear solutions to the pain, neuroplasticity could provide relief. Neuroplasticity-based methods can be utilized to incrementally retrain the brain’s response to the so-called “fear-inducing stimuli” that lead to this hyperreactivity.
Symptoms of Central Sensitization Syndrome
Some of the common symptoms associated with Central Sensitization Syndrome include sensitivity to:
- Touch: Excessive pain associated with touch sensations is common in pain disorders.
- Light: For example, the lighting in a room may lead to headaches..
- Sound: Sounds may cause emotional distress and lead to anxiety.
- Odors: Innocuous odors may elicit a strong negative reaction.
- Cognition: In a noisy or chaotic environment, you may find it difficult to concentrate.
A persistent hyperactive nervous system or otherwise known as Central Sensitization Syndrome, has also been implicated in:
- Chronic Lower Back Pain
- Chronic Neck Pain
- Whiplash Injuries
- Chronic Tension Headaches
- Migraine Headaches
- Rheumatoid arthritis
- Osteoarthritis of the knee
- Motor Vehicle Injuries
- After Surgery
- Chronic Fatigue Syndrome
There are many ways in which central sensitization can be symptomatically experienced. The nervous system helps to process sensations like pain, but it also helps to process our emotions. Most environments will stimulate the nervous system, especially when experiencing new information. For example, entering a new room, wearing a piece of clothing, or going to an event.
However, when the nervous system is in a constant state of hyper-reactivity, thoughts, and feelings may be experienced more intensely as well. The constant intensity and sensitivity to stimuli can then lead to anxiousness or constant worry. Feeling alone may lead to your thoughts and feelings not being validated.
Despite the fact that central sensitization is not experienced by many people, it is important to know that there is encouragement and integrative support available. This is one of the main drivers behind re-origin; supporting those who feel isolated and stuck.
Causes and Risk Factors of Central Sensitization Syndrome
There is yet hope for those who are troubled by central sensitization, which frequently results from two factors.
- Those who experience a state of physical change to the central nervous system and experience symptoms due to a previous pain condition or traumatic experience.
- Those who experience a state of physical change to the central nervous system and experience an onset of symptoms due to the primary pain condition or traumatic experience.
Reasons for a physical change to the central nervous system can include:
A leading trigger for symptoms can differ from person to person based on the context of an individual’s life. In both cases, physical changes can affect how someone might perceive somatosensory stimuli differently than before. In a study entitled “Central Neuropathic Pain Syndromes” in the Journal of Mayo Clinic Proceedings found that 20-40% of those with multiple sclerosis have experienced pain-related sensory sensitivity, while 31% of those with a spinal cord injury have similar experiences.
Other factors that can increase the modulation of heightened sensitivity to pain include examples such as depression, past physical or emotional trauma, and a history of anxiety related to pain. Incremental brain retraining through our program here at re-origin is providing an evidence-based impact with real and empowering change to support those feeling isolated with their symptoms and ongoing attempts at pain management.
How Central Sensitization Syndrome is Diagnosed?
Since there are so many different overlapping symptoms that can affect the experience of central sensitization, many people have multiple different diagnoses and comorbidity. However, a study in the Journal of Annals of Internal Medicine suggests that a diagnosis of Central Sensitization Syndrome largely depends on the person’s primary complaint, their most worrisome symptom, or the clinician’s subspecialty.
How Central Sensitization Syndrome is Treated?
The good news is that there are multiple different central sensitization treatments. A Study entitled “Central Sensitization Syndrome” and “The Initial Evaluation of a Patient with Fibromyalgia: A Review” in the Ramdam Maimonides Medical Journal found that trying a few different treatment options can be effective in helping desensitize the hyperreactivity of the central nervous system, although treatment will vary from person to person.
Antidepressant and anticonvulsant medications are pharmacological options that are also sometimes considered. Non-pharmacological treatments can include:
- Cognitive Behavioural Therapy
- Mind-body Techniques
- Paced Breathing
- Sleep Hygiene
- Graded Aerobic Exercise
A major consideration is to focus on building new neural pathways in key sensory input regions of the brain. In the re-origin neuroscience-based program, we focus on helping to equip you with tailored activities and non-pharmacological treatments to empower you in your healing journey.
- Harte, S. E., Harris, R. E., & Clauw, D. J. (2018). The neurobiology of central sensitization. Journal of Applied Biobehavioral Research, 23(2). https://doi.org/10.1111/jabr.12137
- Aaron, L. A., Burke, M. M., & Buchwald, D. (2000). Overlapping Conditions Among Patients With Chronic Fatigue Syndrome, Fibromyalgia, and Temporomandibular Disorder. Archives of Internal Medicine, 160(2), 221. https://doi.org/10.1001/archinte.160.2.221
- Nursalim, M., Hidayah, N., Atmoko, A., & Radjah, C. L. (2020). Ego State Therapy (EST) and Systematic Desensitization (SD) to Reduce School Refusal among Senior High School Students. Indian Journal of Public Health Research &Amp; Development, 11(1), 1260. https://doi.org/10.37506/v11/i1/2020/ijphrd/194015
- Fleming, K. C., & Volcheck, M. M. (2015). Central Sensitization Syndrome and the Initial Evaluation of a Patient with Fibromyalgia: A Review. Rambam Maimonides Medical Journal, 6(2), e0020. https://doi.org/10.5041/rmmj.10204
- Latremoliere, A., & Woolf, C. J. (2009). Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity. The Journal of Pain, 10(9), 895–926. https://doi.org/10.1016/j.jpain.2009.06.012
- Watson, J. C., & Sandroni, P. (2016). Central Neuropathic Pain Syndromes. Mayo Clinic Proceedings, 91(3), 372–385. https://doi.org/10.1016/j.mayocp.2016.01.017