Central Sensitization

Central Sensitization: The Root Cause of Your Child's Pain?

The Root Cause

In a typical pain response, a message is sent from our body to our brain to trigger an alarm that is designed to protect us. The brain responds by sending signals to your muscles to move, telling your blood vessels to constrict, or increasing blood flow to the area in need. 

For example, if you put your hand on a hot stove, your body sends a message to your brain which then sets off an alarm saying “Ouch!! Something needs attention!”

The brain quickly responds by lifting your hand off the stove. At the same time, your brain quickly tells your blood vessels everywhere except your hand to constrict, while sending increased blood flow to your hand that may need attention. 

Once the body removes the painful stimulus and goes through its healing process, the pain signal from the body to the brain stops. The alarm goes quiet, and we no longer experience the pain. 

However, sometimes, the alarm doesn’t go off like it is supposed to. Instead, the alarm changes. 

The technical term for this type of change is called “central sensitization”. Central sensitization is a condition in which the nervous system becomes overactivated and  oversensitive. As a result, it amplifies pain and other sensations, usually long after the original injury or trigger is removed or resolved. 

Central Sensitization may be the root cause of many chronic pain conditions, including AMPS, CRPS, and Juvenile Fibromyalgia. 

Understanding Central Sensitization

If we think of your central nervous system (brain and spinal cord) as a fire alarm. When working typically, a fire alarm will sound an alarm when there’s smoke from an actual fire; a truly painful stimulus. However, sometimes the body’s response or the way that the central nervous system is processing that initial fire (injury, illness, etc.) can cause the central nervous system to change. 

This change can cause the central nervous system to become over sensitive and overreactive. Now, in this “sensitized” state, the fire alarm may go off when you do not want it to do so, for instance, if you turn on your toaster or light a candle – the alarm is over-sensitive or falsely interpreting the stimuli. Now your body may respond to painful stimuli with a disproportionately large pain response and/or respond to non-painful stimuli as painful. Your nervous system is now acting as an overly sensitive fire alarm, no matter what the stimuli. 

Understanding Our Nervous System 

Our nervous system is designed to learn and adapt, which most times is beneficial to us. However it also can be problematic when repeated pain, stress, injury, illness, or trauma re-train the brain and spinal cord to become over-reactive.

Over time, several things can happen:

• Pain becomes disproportionate to the cause 

• Typically non-painful sensations may begin to hurt or feel painful

• The body becomes more reactive to stress

• Muscles may stay tense and guarded

• Sleep may become disrupted

• Fatigue and brain fog can increase

• The nervous system remains stuck in “fight-or-flight” mode

In simple terms, the volume knob for danger signals gets turned up too high.

Restoring Hope

In the case of central sensitization, the pain that a person is experiencing is “real”, despite the fact that all traditional medical testing and imaging will suggest that “everything looks normal”. This can be an incredibly overwhelming and frustrating situation when your child is experiencing this type of pain. Conditions associated with central sensitization do not show on imaging or lab work because central sensitization involves changes in how the nervous system processes information, not necessarily changes at the site of the initial injury.

The nervous system is adaptable. Just as it can learn sensitivity, it can also learn safety, resilience, and appropriate regulation again over time. And you and your child can learn to restore hope, confidence, and joy in your child’s movement and activity. At Strong Roots PT, we are here to help your child, as well as you and your family, on that journey.