Is Your Pain Caused by Nervous System Sensitivity?
Summary
Central Sensitization is a form of pain that is caused by nervous system sensitivity rather than tissue damage or nerve damage. It is also called neuroplastic pain or nociplastic pain.
Pain is the nervous system’s way of alerting you to potential danger. Central Sensitization happens when the nervous system feels unsafe and interprets a wide range of sensory stimulation as dangerous.
Unlike acute or nociceptive pain, the symptoms are disproportionate, easily activated, and hard to control.
Pain due to injury decreases over time as the injury heals.
Pain due to central sensitization increases over time because the longer the threat level stays elevated, the louder the pain alarm will get.
Chronic pain is often hard to diagnose and treat because it is not associated with structural damage. If you have persistent pain but do not have a clear diagnosis, despite seeing multiple doctors and having multiple tests, your pain may be due to nervous system sensitivity.
This article will explore the causes, signs, and symptoms of central sensitization to help you understand why you hurt and get started on the path to healing.
What Causes Pain?
When you have pain, you usually want to know what is causing the pain. Modern medicine relies on diagnostic imaging, such as an MRI or X-ray, to identify a structural cause of pain, so it is natural to believe that pain is caused by injury.
Unfortunately, this is the reason why the diagnosis and treatment of chronic pain often fails.
Pain is NOT due to tissue damage, it is an alert from the nervous system that there may be a threat, and it is designed to protect you.
If you put your hand on an object that could burn you, your sensory receptors will detect a temperature that is outside of the safe range and will alert your nervous system. Your nervous system will send a pain signal to get you to move your hand so that you don’t get hurt.
The pain circuit can be activated by safe sensory input if your nervous system believes it could be dangerous.
There is a famous story in the pain world about a construction worker who stepped on a nail. He looked down and saw a large nail sticking up from the sole of his shoe through the top of his foot. He experienced intense pain, which was a positive protective response because it caused him to seek medical care.
When the doctors cut off his boot, they found that the nail did not pierce his skin!
You might be wondering why he had so much pain when there wasn’t any injury.
This person had pain because his nervous system believed there was danger.
If you saw a nail sticking up out of your foot, you would have pain, too!
Pain is an alarm. Seeing the nail caused the construction work to seek medical attention. If there had been an injury and he didn’t feel pain, he might have caused more damage or gotten an infection by ignoring the problem.
What this story tells us is that perception plays a large role in pain, and that pain is caused by the nervous system, not by the individual tissue.
What is Central Sensitization?
Central Sensitization is a chronic pain condition caused by nervous system hypersensitivity.
The body has thousands of sensory receptors in the skin, joints, muscles, tendons, ligaments, bones, and visceral organs, as well as the sensory organs.
These sensory receptors detect changes in the internal and external environments.
Sensory information is sent via nerves from the body to the spinal cord where it is reviewed. Interneurons in the spinal cord act like a bouncer at a bar, or an executive assistant to the CEO and decide which sensory information is relevant enough to granted exclusive access to the brain.
The interneurons typically filter out general sensory information, such as the feeling of your clothing touching your skin, so that you aren’t distracted and overwhelmed by information.
When the nervous system becomes sensitive, access to the brain becomes less exclusive, and the interneurons share more information with the CEO in the brain.
This causes the nervous system to become concerned that there is danger, which makes the alarm system more sensitive.
Think about it: When you sense there is danger, your senses become heightened and you are more aware of your surroundings. You are likely more jumpy and investigate every noise, movement, or feeling because you are worried that you might not be safe.
Central Sensitization is like a very sensitive fire alarm system. We want the fire alarm to be activated when there is a real fire, but we don’t want it to be activated when we are cooking dinner.
If your central nervous system has become sensitive, the alarm may be activated by safe sensations, such as light touch, changes in temperature, or simple movements.
The pain is not being generated by an injury, but rather by a nervous system that feels unsafe and is evaluating everything as a potential threat.
Central Sensitization Symptoms
Central sensitization often doesn’t have a clear cause and can occur without any injury.
Many people who have central sensitization have seen multiple specialists and don’t have a clear diagnosis because the diagnostic tests don’t reveal any specific injuries or structural damages, or their symptoms are not proportionate to the findings on an MRI or X-Ray.
Sometimes central sensitization begins with an injury, but instead of the pain getting better when the injury heals, the pain persists or gets worse. Pain that lasts after an injury has healed is a clear sign that the nervous system has become sensitized.
How do you know if your pain is caused by nervous system sensitivity?
Here are some of the main signs that your pain is due to central sensitization:
You have pain that has lasted for longer than the typical tissue healing time of 6 - 12 weeks.
You have pain, but you never had an injury or any tissue damage.
Your pain has gotten worse, not better, over time.
Your pain comes and goes, migrates, or spreads.
Your pain gets worse when you are stressed or sick.
Your symptoms are influenced by time of day, environmental temperature, or weather patterns.
Your symptoms are activated by smells, memories, sounds, or thoughts.
Your symptoms are activated by the anticipation of an activity or movement that makes you nervous.
Your pain began during a stressful time in your life.
You have pain on both sides of your body, or in multiple areas of your body.
You have pain, but you don’t have a diagnosis because X-rays and MRIs did not show any tissue damage.
You’ve seen multiple healthcare providers and have had many tests and scans.
No one can really explain why you still hurt.
Pain impacts your ability to do functional, occupational, and/or recreational activities.
You sometimes have a delayed reaction to pain. An activity might not hurt in the moment, but later you will have pain.
You have a history of childhood trauma or adversity.
You have a tendency towards perfectionism, people pleasing, high responsibility, and/or anxiety.
These are all signs that the nervous system is sensitive and the pain alarm is easily activated.
The Impact of Central Sensitization
Just like when a fire alarm is activated in a building and everyone must pay attention, pain does not just affect a body part; it impacts all aspects of life.
If you have a sensitive nervous system, you may have some or all of the following comorbid symptoms associated with chronic pain or persistent pain:
Anxiety, sadness, and/or depression.
Clenching or grinding teeth or jaw pain/TMJ disorder
Headaches or migraines
Diarrhea, constipation, or IBS
Pain or burning with urination
Frequent urination
Pelvic pain
Fatigue, poor sleep, and/or restless legs
Difficulty concentrating or focusing
Poor memory
Skin dryness, itching, or rashes
Low energy or chronic fatigue
Loss of function
Sensory sensitivity (including sensitivity to fragrances or other smells, light, sound, or temperature)
Hormone dysregulation
Frequent sickness
Respiratory disorders, such as asthma or COPD
Examples of Sensitive Nervous System Diagnoses
There are many diagnoses associated with nervous system sensitivity that all have a similar cluster of signs and symptoms described above.
Here are some examples of diagnoses associated with central sensitivity:
Restless Leg Syndrome
Chronic Fatigue Syndrome
Long COVID
Fibromyalgia
Temporomandibular Joint Disorder (TMJ Disorder)
Migraine or tension headaches
Irritable Bowel Syndrome (IBS)
Multiple Chemical Sensitivities
Mast Cell Activation Syndrome
Whiplash
Chronic Lyme Disease
Ehler’s Danlos Syndrome (EDS) or other connective tissue or hypermobility syndromes
Other autoimmune and rheumatological conditions
PTSD
Learn More
To learn more about the three different types of pain, and the different diagnosis and treatment options, please read this article:
Why Chronic Pain Needs a Different Approach: Understanding the 3 Types of Pain
Help is Available for Central Sensitization
I specialize in helping people with chronic pain syndromes decrease the intensity and sensitivity of the pain alarm by reducing the hypersensitivity of the nervous system.
CranioSacral Therapy in Shelburne, VT
For those who live near Chittenden County, VT, I offer CranioSacral Therapy to activate the Parasympathetic Nervous System and unwind the physical, emotional, and energetic tension associated with pain, enabling the body to heal.
CranioSacral Therapy is a form of manual therapy for the nervous system that is incredibly effective at reducing central sensitization pain by treating the root causes. CranioSacral Therapy helps the nervous system feel safe, reducing the sensitivity and intensity of the pain alarm.
Physical Therapy for Chronic Pain in Shelburne, VT
I also offer Integrative Physical Therapy specifically for people with central sensitization. Conventional physical therapy diagnoses and treats tissue injury with a biomechanical approach.
When I work with people with central sensitization and chronic pain, I take a whole-being approach to healing the nervous system that addresses all the systems of the body, mind, and spirit to help the nervous system feel safe.
This approach includes Pain Neuroscience Education, vagus nerve reset exercises, and mind-body training to rewire the nervous system, reduce nervous system sensitivity, improve sensory discrimination, and reduce pain associated with nervous system sensitivity.
If you are experiencing any of the signs, symptoms, or diagnoses described in this post, I would love to guide your nervous system back to resilience. Schedule a Free Discovery Call to connect and learn more about my nervous system-informed approach to pain.
Virtual Offerings
Break the Pain Cycle: Online Pain Neuroscience Course & Group Coaching Program
Pain neuroscience education is actually more effective than medication at reducing pain and improving function!
If you want to learn more about the science of pain so that you can finally break the pain cycle, join the waiting list for the next round of my Break the Pain Cycle Program. This course will introduce you to the fundamentals of pain neuroscience and teach you how to help your nervous system feel safe so that it is less sensitive and more resilient.
The Break the Pain Cycle Program is offered virtually so you can join from anywhere in the world.
Questions?
If you would like to learn more about my approach and whether it would be a good fit for you, let’s connect. I’m happy to help you determine what type of pain you have and provide a recommendation for treatment.
