What is Central Sensitization Syndrome?

The Pain Rehabilitation Center (PRC) recognizes what is known as Central Sensitization Syndrome (CSS). This is an umbrella term used to describe pain and symptoms that arise from hypersensitization of the nervous system.

To best understand CSS, it is important know about the nervous system. Our nervous system is made up of two main parts: the central nervous system and the peripheral nervous system. The central nervous system acts as the control center of the body, consisting of the brain and spinal cord. The peripheral nervous system consists of all the nerves outside of the brain and spinal cord that act as the communication network. The peripheral nervous system sends sensory information to the central nervous system and delivers the central nervous system's commands to the rest of the body. Together, the central and peripheral nervous system work as a team to control the body's functions.

CSS is a phenomenon that alters how sensory stimuli is processed by the nervous system. Imagine your nervous system as a highway and that the neurons are vehicles carrying information along it. The highway is usually monitored by a patrol that regulates traffic, ensuring that the vehicles travel efficiently. However, with CSS, the highway becomes dysfunctional and allows too many vehicles to travel too frequently and at higher speeds. As a result, the highway becomes hypersensitive. Now, even the most minor disturbance, such as the vehicle in front of you lightly taping their breaks, causes a major chain reaction.

Increased traffic along the highway can be compared to the hyperexcitability of the nervous system. The nervous system sends too many alert signals even when there is no real danger, much like a congested highway with no major accident. Ultimately, CSS turns a once-efficient neural highway into a hypersensitive, traffic-jammed system in which sensory signals are sent too often and too intensely. The brain becomes accustomed to this influx of signals and now has a decreased threshold for pain and symptoms.

Our nervous system has the incredible ability to functionally and structurally change so that we can adapt to new situations and absorb new knowledge. However, this ability can become maladaptive just as it has with CSS. Although the cause of the highway traffic has been resolved, the effects progress on. Once the central nervous system is altered, it cannot return to its previous form because the brain has structurally created these new traffic systems. This is why CSS cannot be cured with medication or procedures. However, by applying an interdisciplinary approach to rehabilitation, we can leverage the mechanisms that enable our nervous system to learn and adapt to also manage CSS.

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