Central Sensitization: When Pain Just Won’t Go Away

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Bodily aches and pains are part of the human experience. They come and go, and vary in intensity, depending on the event or stimulus that triggered them, and the measures taken to treat and manage them. In most cases, pain has a specific and treatable underlying cause, but for some people, a chronic heightened hypersensitivity to even mild stimuli persists, a condition called central desensitization.

Understanding Central Sensitization

Pain scientists have only recently begun to unravel the mechanisms that contribute to a heightened pain response in certain individuals. Conditions like fibromyalgia, chronic neck pain, low back pain and other chronic pain syndromes often have no underlying mechanical causes. Even in patients with degenerative disc disease where there are mechanical changes, only a small minority report chronic pain, and many patients report no pain at all.

We are now beginning to understand that pain itself can alter the central nervous system in ways that heighten sensitivity to pain. In essence, for some people, pain begets pain, making even a mild touch or the slightest pressure a source of agony. Pain scientists suspect that chronic pain that will not go away for months on end is fueled by the CNS, and not by the original source or locus of pain.

Factors Influencing Central Sensitization

Central Sensitization is broadly recognized among pain scientists as a very real medical condition, but what puzzles researchers is why some people experience it while others do not.

Some possible contributing factors include:

  • genetics
  • environmental factors
  • stress
  • psychological factors
  • poor sleep quality

Whatever the cause, it is suspected that untreated or under-treated pain eventually rewires the central nervous system, causing the brain to misinterpret certain stimuli as a threat. In effect, pain become a sort of defense mechanism, warning you of danger in a way similar to the pain you feel when touching a hot surface. And the worst part is that every pain response feeds central nervous system dysfunction, causing an escalating spiral of pain and increased sensitivity.

Medical Treatment and Central Sensitization

Currently, pain science is a hot topic in research, but sadly, many medical practitioners are unaware of the central sensitization phenomenon, which is bad news for patients suffering from chronic pain. Patients may undergo expensive and ineffective therapies and surgeries in a quest to find a solution, and chronic pain syndromes are no doubt contributing to the opioid epidemic as patients become addicted to pain pills.

In some instances, doctors may dismiss patients complaining of chronic pain, telling the patient, “It’s all in your head,” which, ironically, it is. Pain is your brain’s interpretation of a stimulus. In many cases, the locus of pain can be distant from the source, making it futile to attempt to treat the painful region.

In an effort to help alleviate patients’ suffering, well-meaning massage therapists, chiropractors and physical therapists may treat CS patients too aggressively, triggering a CNS response that worsens the pain, rather than relieving it.

Treatment for Relentless Chronic Pain in NYC

If you have been suffering from ongoing pain that does not respond to treatment, you need a therapist who understands central sensitization and how it affects the central nervous system. At NYDNR, we work with CS patients to retrain the brain and central nervous system, to stop the spiral of pain sensitivity. Our clinic features cutting-edge technologies and innovative therapies that are rarely found in the average rehab clinic. Do not resign yourself to a life of endless pain. Contact NYDNR today, and turn the tables on pain so you can enjoy a better quality of life.

130 West 42 Street Suite 1055, New York NY 10036
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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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