Central Sensitisation Syndrome
Central Sensitisation Syndrome is a condition of the nervous system that is associated with the development and maintenance of chronic pain. With CSS, the nervous system goes through a process called “wind-up” and gets stuck in a state of high reactivity. This state of reactivity subsequently comes to maintain pain even after the initial injury might have healed.
Central sensitisation has two distinct characteristics which are called ‘allodynia’ and ‘hyperalgesia.’ Allodynia occurs when a person experiences pain with things that are normally not painful, for example, basic soft touch or massage may cause pain. Hyperalgesia occurs when an actual painful stimulus is perceived as more painful than it should. An example would be a small knock or bump which normally may only be mildly painful, will give the chronic pain patient an extremely painful experience.
1. Latest News
For information on muscle and connective tissue pain, refer to our section on Fibromyalgia here
For information on joint pain, refer to our section on Arthritis here
2. Symptoms and Treatments
Note: Always seek advice from a doctor before beginning any listed treatments. Treatments can affect everyone differently.
Headaches may be due to brain or skull structure, or due to infections and inflammation, but the mot common cause of headaches is stress. It is important to see your doctor if you experience headaches of a new or more severe nature.
Painkillers for Central Sensitisation Syndrome:
Such as paracetamol can provide temporary symptom relief.
Trycylics for Central Sensitisation Syndrome:
Such as Amitriptyline, Nortriptyline and Doxepin are old style antidepressants which may be used to improve sleep and also give symptom relief for headaches.
Anti-migraine drugs for Central Sensitisation Syndrome:
are available to provide relief. Patients can be very sensitive to medication so always start on slow dosages.
Mindfulness for Central Sensitisation Syndrome:
Mindfulness is a strategy that has many health benefits including controlling pain. More info
Acupuncture and acupressure for Central Sensitisation Syndrome:
Have been used in china for years to help relieve pain and poor circulation.
The cold approach:
Headaches can be sometimes be relieved by going for a cold swim or putting a cold crystal band around the head. The coldness shrinks the blood vessels and relieves pain and pressure.
Willow bark for Central Sensitisation Syndrome:
can help relieve pain as well as aspirin. It contains the same ingredient as aspirin so those sensitive to aspirin and those with sensitive stomachs should avoid.
These pains include joint pain, muscular pain, headaches, gastrointestinal, bladder, menstrual and lymph gland pain too. Widespread muscle and connective tissue pain is known as Fibromyalgia - more information on Fibromyalgia here
Analgesics for Central Sensitisation Syndrome:
Such as paracetamol or aspirin work best for localised pain. For more serious pain there is codeine and tramadol. For very severe pain prescription drugs include morphine, oxycodone and pethidine.
NSAIDs for Central Sensitisation Syndrome:
work by reducing inflammation. Diclofenac, ibuprofen and naproxen are good for sprains, strains, infection related pain and joint pain associated with arthritis. These medications can be quite harsh on the stomach and many CFS/ME patients cope with a subsidary medication known as COX-2 inhibitors such as celecoxib.
Anticonvulsants for Central Sensitisation Syndrome:
such as carbamazepine and sodium valproate are drugs intended for chronic pain which decrease `electric impulses` and decrease our experience of pain. The dose needs to be built up gradually over time and initially you may experience side effects however most of these go away with time. As with any medication, discuss with your doctor.
Working with a trained practitioner can assist you to develop skills to calm anxiety and can also equip you with knowledge to find your next steps towards wellness. Please ensure that you find a practitioner who understands how to navigate the territory of complex chronic health conditions.
Mindfulness for Central Sensitisation Syndrome:
Mindfulness is a strategy that has many health benefits including controlling pain. Mindfulness is a set of skills for healing, intuition, insight, calmness, focus, resilience and hope that you can develop to counter the stresses that chronic illness brings. You can literally "train your mind to promote healing. Mindfulness has a positive flow on affect into every aspect of a person’s life. More info
Acupuncture and Hypnosis for Central Sensitisation Syndrome:
Are methods that have been proven to relieve pain in some individuals.
Willow Bark for Central Sensitisation Syndrome:
A natural painkiller that contains the same active ingredient as aspirin. Avoid if you have an aspirin sensitivity.
Omega 3 Fish Oils for Central Sensitisation Syndrome:
Help to block inflammatory cytokines, and may give pain relief to some.
Olive Oil for Central Sensitisation Syndrome:
Contains similar properties to ibuprofen.
Capsicum Cream for Central Sensitisation Syndrome:
Can be used for localised joint or muscle pain. Use carefully and avoid broken skin as it can burn.
3. Diagnosis and Tests
It is very difficult determining exactly how much pain a person has. Imaging technology can be used to locate pain precisely, and to assess the effect that pain has on someone, however they do not provide objective measures of pain.
With headache pain, physicians find that the best aid for diagnosis is the person’s own description of the type, duration, and location of pain. Defining pain as sharp or dull, constant or intermittent, burning or aching may give the best clues to the cause of pain. These descriptions are part of what is called the pain history, taken by the physician during the preliminary examination of a person with pain.
There are a number of approaches and technologies to find the cause of pain. Primarily these include:
A musculoskeletal and neurological examination which tests the patients movement, reflexes, sensation, balance, and coordination.
Laboratory tests (e.g. blood, urine, cerebrospinal fluid) can help to diagnose infection, cancer, nutritional problems, endocrine abnormalities and other conditions that may cause pain.
Electrodiagnostic procedures include electromyography (EMG), nerve conduction studies, evoked potential (EP) studies, and quantitative sensory testing. These procedures measure the electrical activity of muscles and nerves.
Imaging, especially magnetic resonance imaging or MRI, provides pictures of the body's structures and tissues, such as the brain and spinal cord. MRI uses magnetic fields and radio waves to differentiate between healthy and diseased tissue.
X-rays produce pictures of the body's structures.