Chronic Pain: Central Sensitization

By January 14, 2022 January 24th, 2022 No Comments

If you have been in pain for longer than 3 months, the odds are good that you have developed some type of chronic pain syndrome.  Central Sensitization is one form of chronic pain that involves the body being “sensitized” to pain even after the injury has healed.  Read on to learn more.  

What is Pain?

To understand why this happens, it’s important to first understand what pain is.  When your spine and brain get information from the nerves out in the body, that input gets processed and eventually registers in your conscious mind.  For example, the nerve endings in the hand get pushed on, and then the brain figures out, “oh, this is physical pressure on the hand.”  It then has to determine how much pressure there is and what it should do about it.  If the sensation is familiar and mild, you feel it as a touch.  

Woman burning her hand experiencing pain

However, if the sensation is new and intense, the result may be different.  The brain may interpret the nerve getting pushed as a threat.  Our brains are particularly wired to survive by avoiding danger, so we have a special category for this input—pain.  

Pain is your brain’s assessment of threat level.  It’s your brain trying to tell you how dangerous something is so you can decide if you should let it keep happening or get away fast, like a caveman running away from an attacking tiger.  This is the primitive, reflexive part of the brain communicating to the conscious, decision-making part the best way it knows how.  

It’s worth noting that the spinal cord can process the information by itself and react so quickly that you aren’t even aware of the sensation.  A good example of this is when you pick up a hot casserole and suddenly jerk your hand away before you even feel it!  

How Does Pain Become Chronic?

Here’s the thing about pain—your brain won’t let you just ignore it forever.  Remember, it is interpreting that input as a threat, and it wants you to get away from the danger, to run away from the tiger.  But what if the pain is not something you can run from, such as back muscle spasms?  Over time, the brain will gradually turn the amplifier up higher and higher and higher in an attempt to get you to escape.  This is why many of those with chronic pain have 9 or 10 out of 10 pain so much of the time.  

How Can Non-Dangerous Inputs Feel Painful?

Because the brain has turned the amp up so high to get your attention, now ALL sensory input gets amped up as well!  I often encounter people who have had a back injury, but pressure to the hand, bright light, or loud noise actually feels painful too.  When you reach this level, you have central sensitization; your brain is “sensitized” to all the input and starts interpreting it as a threat.  

Part of the brain’s decision about threat is also interpreted through your memories and emotions.  If you originally injured your back lifting something, the brain is going to signal red alert whenever you try bending, grabbing, and pullin; even though this may be what you need to heal your injury! 

Looking at brain scans regarding brain sensitivity to pain

What Can I Do About Chronic Pain?

Remember the example of grabbing a hot casserole?  Often, we don’t actually drop the casserole, because our conscious brain can override the reflex to pull the hand away (because we don’t want to ruin dinner!).  Similarly, your conscious brain can override the primitive brain’s input and tell it that the sensation is not dangerous (or at least not dangerous enough to stop you).  This takes training over time, and this is where a physical therapist can help.  

At Kintsugi Physical Therapy and Wellness, we give our patients attention and time to work through chronic pain and heal.  What sets us apart is our individualized approach that incorporates the whole person instead of applying a cookie-cutter protocol to everyone.  Our therapists are skilled at applying the “just right” level of challenge and encouraging you to succeed beyond your goals.  If you or someone you love is suffering from chronic pain, call us at 253-330-8518 to schedule an evaluation.

Now Providing Telehealth Services!Learn More
Call Now