Central & Peripheral Sensitisation
Your brain stores information from your past and constantly collects messages from your joints, muscles, nerves and skin, the pain you experience is the summation of every piece of information it processes. Your brain uses this information to decide whether you feel pain, or not, often depending on the context.
Common Signs & Symptoms
- Sensitivity to touch which is out of proportion to the stimulus (can also be called allodynia)
- Movements which are normally painless are painful
- Anxious or worried about causing pain, often avoiding the pain
- Pain has usually been present for a period of time
- Pain is stronger if you have anxiety, stress or feel low (depression)
- Increased sensitivity to touch and movement
Your brain stores information from your past and constantly collects messages from your joints, muscles, nerves and skin, the pain you experience is the summation of every piece of information it processes. Your brain uses this information to decide whether you feel pain, or not, often depending on the context. For example, if you have fallen off a bike in the past, falling off again will make you remember the cuts and grazes you had and you become protective of your body, even if this fall was far less traumatic.
Pain is nasty, it changes the way we think, behave and feel, and it frightens us. When we have it we can’t seem to think of anything else, we just want it to stop. Despite all of that, short term pain is useful, it gets us out of danger and makes you take away the stress on damaged tissues and promote healing. In most cases, chronic pain (pain lasting longer than 3 months) is a sign you have a change in the wiring of your pain systems. This means that your pain stays well beyond the time it takes to heal your tissues.
Pain is your body's way of protecting you from dangers which can damage your tissues from (for example) heat, trauma, pressure or moving a joint too far. When you experience pain (past and present) it teaches you to avoid the things which cause it. By releasing certain chemicals (neurotransmitters), your brain can make you feel more pain when you do normal everyday tasks - this makes you rest an injury so your body can heal. The number of chemicals your brain releases is also tied to your emotions which is why feelings such as anxiety, stress or depression can heighten your sensation and lead to more pain. This is entirely normal but if your brain continues to produce these chemicals which it can when you suffer from anxiety, stress or depression, your body can stay sensitive and it will hurt to do normal things, even when your tissues have healed up. This change in the way you feel pain is a bit like a 'pain melody' going around and around in your head and is called sensetisation.
Central sensitisation - is where you feel more pain originating from your brain and spinal cord - this is usually when your brain nerves become more excitable and produce chemicals following repeated stimulation of the nerves. The brain develops a memory of this stimulation to produce a response, and every time it occurs this becomes stronger, causing increased nerve excitability and therefore stronger response. Peripheral sensitisation is where any nerve (outside of your brain and spinal cord) is more sensitive than normal – messages are sent to your brain saying that your body is in danger even after your tissues are better. Both cause you to experience more pain and are thought to be one mechanism of developing chronic pain.
Advice & Treatment