Central sensitization: a matter of concern

I walk too much I get terrible pain in my legs, do things with my arms, pain in arms and so on. The pain is a direct result of doing too much and is best explained, for me anyway, by the low AT findings.

In MS, whichever nerve becomes damaged is where the disability comes. They emphasise that someone in a wheelchair just has different nerves damaged from someone who walks well and does not necessarily have a more serious disease.

In ME, if it is energy production in the gut, say, that is most affected there will not be the same pain as if the legs were affected.

I cannot take enough painkillers to get rid of my pain so I actually thole it better than most people as I live with it constantly. I have had root canal work done without anaesthetic. It was unpleasant but I have tricks for tuning out pain.
 
This Central Sensitisation idea should be tested in other patient populations for veracity, for bias. Because no one who is exhausted, (parents of babies, the overworked), and/or suffering from an illness can cope well with additional pain.

Or are they saying that Central Sensitisation is the cause of our illness? And therefore not giving in to our symptoms, ignoring them, "toughening up", is the cure? Probably.

How IS it tested anyway? They don't have a base line of how pain sensitive each of us were BEFORE we got ill. How can they tell that we're ALL so much more sensitive to painful stimuli now?

They can't. I think they generalise from a tiny sample they handpick, and extrapolate. Then smear us all with this label. This pejorative label.
 
Last edited:
Squeezy said:
Or are they saying that Central Sensitisation is the cause of our illness? And therefore not giving in to our symptoms, ignoring them, "toughening up", is the cure? Probably.
Click to expand...

"Central sensitisation" is code for: there is something wrong in the brain that is amplifying the perception. The implication is the perception is inaccurate. It is a hypothetical concept that dates back centuries.

The irony is there are no demonstrable biological models for central sensitisation. Peripheral sensitisation has been demonstrated in animal models, but generalisations of this is by analogy only.
 
Last edited:
Squeezy said:
This Central Sensitisation idea should be tested in other patient populations for veracity, for bias. Because no one who is exhausted, (parents of babies, the overworked), and/or suffering from an illness can cope well with additional pain.

Or are they saying that Central Sensitisation is the cause of our illness? And therefore not giving in to our symptoms, ignoring them, "toughening up", is the cure? Probably.

How IS it tested anyway? They don't have a base line of how pain sensitive each of us were BEFORE we got ill. How can they tell that we're ALL so much more sensitive to painful stimuli now?

They can't. I think they generalise from a tiny sample they handpick, and extrapolate. Then smear us all with this label. This pejorative label.
Click to expand...

Just from memory I think there is research it is based on. The problem is that it would be imaging (MRI) on the hypothalamus-pituitary axis (HPA). And whatever is showing up is being interpreted. Our understanding of the brain and it's functioning is primitive. Some basic knowledge of the HPA is being used to hypothesize way beyond what is reasonable IMO.

And I think they are also using as support the work by Ramachandran on phantom limb pain.
 
Snow Leopard said:
The irony is there are no demonstrable biological models for central sensitisation. Peripheral sensitisation has been demonstrated in animal models, but generalisations of this is by analogy only.
Click to expand...
As I understand it central sensitization has been demonstrated, even in humans, but it referred to something very specific, namely a change in the excitability of the central nervous system that is autonomous of the peripheral input that triggered it. This was demonstated by experiments of Clifford Woolf and Robert LaMotte more than 25 years ago.

Since then there has been an inflation of the term central sensitization. Woolf, who has championed this expansion of the term, now defines it as “genus of all forms of pain sensitization that arise within the central nervous system". But this has been a controversial development as in this interpretation CS is no longer evidence based but merely a hypothesis or theoretical concept. Others like Daniel Clauw suggest to use other terms for this concept such as ‘central pain’ or ‘central augmentation’ instead of CS, giving that the term CS was originally used in the context of a sustained peripheral noxious input in an experimental (not a clinical) setting.

There's more information about this on MEpedia.
 
Last edited:
I've screen shot this page, to have on hand to rebut the baseless assertions of anyone foolish enough to utter the words, "Central" and "Sensitisation" in my direction.

Thanks for the science, @Michiel Tack @Snow Leopard and @Snowdrop

Hands up, who's monumentally fed up with these terms being bandied about in relation to us, with absolutely no proof behind them? It feels like slander, not theorising in search of treatment.
 
Michiel Tack said:
namely a change in the excitability of the central nervous system that is autonomous of the peripheral input that triggered it. This was demonstated by experiments of Clifford Woolf and Robert LaMotte more than 25 years ago.
Click to expand...

The CNS sensitisation demonstrated was short term and specific to the nerve(s) stimulated due to the initial injury.

They didn't demonstrate widespread, long term (months to years) increased CNS sensitivity throughout the body, which is what most people now mean when they say central sensitisation.
 
Snow Leopard said:
They didn't demonstrate widespread, long term (months to years) increased CNS sensitivity throughout the body, which is what most people now mean when they say central sensitisation.
Click to expand...
Yes, thats what I meant. Some use the biological evidence for the original, restricted meaning of central sensitization and act like it also applies to the expanded version, which is now dominant.

Now I'm not against the hypothesis of central sensitization, the idea that changes in excitability of the CNS can help explain the chronic pain in many poorly understood diseases. But then they should acknowledge it's merely a hypothesis, one that goes far beyond what experiments have demonstrated. You can't have your cake and eat it.
 
Central Sensitisation 'gains prominence'
Headaches/Migraines in Fibromyalgia and Chronic Fatigue Syndrome
January 28, 2019
Fibromyalgia and ME/CFS belong to a group of illnesses that have been labeled with several different umbrella terms, including "functional somatic syndromes" and "somatic illnesses." Another term that has gained more prominence in recent years is "central sensitivity syndromes." These syndromes are defined as illnesses with physical symptoms that can't be totally explained or diagnosed as an established medical condition.

Migraine has long been associated with functional somatic syndromes, including ME/CFS and fibromyalgia, meaning that the conditions often occur together. Although it's still unclear why this happens, researchers are looking into the possibility that one of the underlying mechanisms the three conditions may share is central sensitization.
Click to expand...
https://www.verywellhealth.com/headaches-and-migraines-in-fibromyalgia-and-cfs-716166
 
If it is central sensitization then injury pain would have it too but it does not in my case. ME pain and pain from a bad injury at the same time respond different.
I noticed that when I had a flare and a horse in full galop flung an iron pipe against my shinbone
 
anniekim said:
I note Belgium Professor of Physiotherapy, Jo Nijs, has his name on a lot of the CS papers.
Click to expand...

I found this article written by him (NOT a recommendation);

https://bodyinmind.org/in-the-mind-...al-sensitization-in-chronic-fatigue-syndrome/

Other ME/CFS articles on that site;

https://bodyinmind.org/catastrophizing-depression-chronic-fatigue-syndrome/

https://bodyinmind.org/cfs-and-understanding-pain-physiology/

Pain specialist, Lorimer Moseley, is a creator of the above site. Not sure if it has been mentioned yet, but it looks like his Tame the Beast video promotes Central Sensitization as an explanation for chronic pain (also NOT a recommendation);

https://www.tamethebeast.org/#tame-the-beast

The tame the beast video/site is targeted at patients, and appears to be a popular education tool for physiotherapists, etc to recommend to patients.

The following suggestion is from
https://www.tamethebeast.org/understanding/

"How do I know if my health professional understands modern pain science?

Ask them these questions (they should say yes to each one!):

Do you understand and believe the biopsychosocial model of pain?"

Hmmm...
 
Last edited:
lansbergen said:
If it is central sensitization then injury pain would have it too but it does not in my case. ME pain and pain from a bad injury at the same time respond different.
I noticed that when I had a flare and a horse in full galop flung an iron pipe against my shinbone
Click to expand...


I had a catharact surgery on monday and the pain was not bad enough to take a painkiller.

How can that be if it is central sensitization?

The operation was so complicated I had to go for an extra check yesterday. The doctor was very relieved to see the lens was in place and everything seemed okay.
 
I had routine nasal surgery in the middle of last year to open up the airway. The pain after was no big deal. Just normal expected soreness for 10 days or so, managed with a few paracetamol and Nurofen, mostly at night to help sleep, and that was it.

ME pain still exactly the same as before.

This central sensitisation thingy is very selective.
 
Michiel Tack said:
This doesn't sound good: "Association between child maltreatment and central sensitivity syndromes: a systematic review protocol."
https://www.ncbi.nlm.nih.gov/pubmed/30782933

CFS is included in the planned review
Click to expand...

I wonder how many of the 'maltreated' children will actually have had ME or EDS or some other un-acknowledged symptoms interpreted as parental abuse, only later to receive a diagnosis, thereby showing how abusive parents cause a whole range of symptoms.

When in fact, they've misdiagnosed symptoms as abuse, then later diagnose the physical symptoms, attributing them to the aforementioned abuse. Cause, meet effect. (Or, bias, meet harm.)
 
Michiel Tack said:
This doesn't sound good: "Association between child maltreatment and central sensitivity syndromes: a systematic review protocol."
https://www.ncbi.nlm.nih.gov/pubmed/30782933

CFS is included in the planned review
Click to expand...

More GIGO. The problem is the lack of prospective studies. What you get is selection bias - eg only people who believe in the association actually submit their questionnaires to the researchers.
 
You must log in or register to reply here.
Back
Top Bottom