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Central Sensitization Syndrome (CSS) treatment approach: Function is the key!

Aug 27 1:30am | Tanya Crowder, OTR/L | @tanyaot | Comments (14)

We explored CSS in a previous post. Let's take a deeper look at its impact.

People with chronic pain and other chronic symptoms may have a central nervous system that has become sensitized over time.  Central Sensitization Syndrome (CSS) can be described as a louder message from the body to a more sensitive receiver in the brain. When you have sensitization, your body overreacts to sensory signals as if they are dangerous. This can result in worsening of symptoms such as pain, fatigue, nausea or other movement related challenges.  The long-term consequences of this upregulated system can include:

  • Physical deconditioning
  • Emotional distress
  • Increased reliance on medications to feel better
  • Increased frequency of treatments or interventions
  • Decreased functioning
  • Decreased quality of life

What is the best approach to address these consequences?

Unfortunately, there is no way to turn back the clock and “un-sensitize” your nervous system. Patients are often left feeling frustrated by the lack of effective treatments.

In the Mayo Clinic Pain Rehabilitation Center (PRC) program, patients learn lifestyle management, stress management and physical re-conditioning strategies to improve their ability to effectively engage in their daily activities.  This approach enables patients to not only improve their functioning, but in time can also lead to improvement in symptoms as well.

Some examples of functional improvement for our PRC graduates:

  • Travel: local and international
  • Vocation: Work, school or volunteering
  • Family life and caregiving
  • Leisure and recreational activities: crafts, reading, kayaking, hiking
  • Community involvement and social activities

Patient outcomes also include improved mood, decreased anxiety, decreased interference from symptoms and a better perception of health.

Getting back to life is the goal and focus on function is an effective tool.

Authors: Kyle Bovee DPT, Tanya Crowder OTR/L and Elke Lacayo OTR/L

 

7 Reactions

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Profile picture for laura1970
laura1970 | @laura1970 | Sep 16 6:47pm
In reply to @rwinney "@laura1970 Your concern is valid. I also had the difficulty of sitting more than 15 minutes..." + (show)
Profile picture for Rachel, Volunteer Mentor @rwinney

@laura1970 Your concern is valid. I also had the difficulty of sitting more than 15 minutes and was able to stand as needed. By the end I was becoming more tolerant and surprised myself by slowly gaining ability. Fun fact, my tolerance continued to improve after getting home and following the program. One of my goals was to sit in a restaurant for a meal with my family without getting up. I now can! I'm able to be more present in the moment.

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I have arachnoiditis of my cauda equina and lumbar spine. I do stretches multiple times per day and weight training 3days a week. I have had this condition for over 5 years and have been through physical therapy at a dedicated spinal cord center (Kennedy Kreiger, affiliated with Johns Hopkins ) multiple times. It hasn’t helped. I keep on because arachnoiditis is a progressive disorder and I can’t know if maybe I am preventing worsening.

So I think I have good reason to doubt that a 3 week session will be helpful. I certainly don’t want to shell out the dough and the discomfort of a long plane ride for a “we can fix it” attitude. What I continue to ask, is do you accommodate this disability? The more my spine is stretched, the less time I am able to sit. I think something like a dialysis or chemo chair would help quite a bit. Could you provide one?

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Profile picture for Tanya Crowder, OTR/L
Tanya Crowder, OTR/L | @tanyaot | Sep 17 10:42am
In reply to @laura1970 "I have arachnoiditis of my cauda equina and lumbar spine. I do stretches multiple times per..." + (show)
Profile picture for laura1970 @laura1970

I have arachnoiditis of my cauda equina and lumbar spine. I do stretches multiple times per day and weight training 3days a week. I have had this condition for over 5 years and have been through physical therapy at a dedicated spinal cord center (Kennedy Kreiger, affiliated with Johns Hopkins ) multiple times. It hasn’t helped. I keep on because arachnoiditis is a progressive disorder and I can’t know if maybe I am preventing worsening.

So I think I have good reason to doubt that a 3 week session will be helpful. I certainly don’t want to shell out the dough and the discomfort of a long plane ride for a “we can fix it” attitude. What I continue to ask, is do you accommodate this disability? The more my spine is stretched, the less time I am able to sit. I think something like a dialysis or chemo chair would help quite a bit. Could you provide one?

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Your concerns and challenges are valid and familiar to us. We are not promising a fix, but a strategy to reduce the difficulties you are having. As part of the admission process, patients are evaluated to determine individual needs and accommodations for program participation.
Please consider taking a look at our Admissions Process tab if you would like to learn more. https://connect.mayoclinic.org/blog/chronic-pain-symptoms-rehabilitation/tab/patient-resources-1/#ch-tab-navigation

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Profile picture for anniesezu812
anniesezu812 | @anniesezu812 | Sep 18 9:57am

I have not been diagnosed with CSS , only CRPS but its obvious I have it. I believe I may have arachoinditis also.
Im NO expert on anything but i am well read re Neuroscience and I dont like the statement in this article ' No way to turn the clock back'. I agree to offer false hope to patients is counter productive but having read extensively on Neuroscience/ brain neuroplasticity i think there maybe hope with many hollistic approaches, it may be possible to de sensitized the Nervous System.
I believe most of us feel good in nature, well it turns out close proximity to Trees can boost immune system, Trees sure improve my mood!
" Grounding" is gaining popularity and whilst im sure the Program offered can be very beneficial i personally refuse to accept this condition for Life! I think attitude/ life style/ mental determination/ hollistic approaches have much to offer than we don't even know of.
Identifying as " sick individuals '' is highly detrimental....how we speak to ourselves influences our body chemistry/ body functions.
Are the above mentioned quick fixes, No but I firmly believe a dedicated ,prolonged effort can improve many conditions that are deemed " progressive/ incurable". You are what you eat/ you are what you speak! You can heal from within...thousands have, why not us!!

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summer1985 | @summer1985 | Sep 20 7:39pm
In reply to @samiam1949 "I suffer from multiple sources of chronic pain and my pain manager has recommended this porgram...." + (show)
Profile picture for samiam1949 @samiam1949

I suffer from multiple sources of chronic pain and my pain manager has recommended this porgram. But,my understanding of the program is that it's 3 weeks, 8 to 5. I am almost 76 and rest every day from 12 to 2 and 8 to 5 is just too long a day for me. Is this information correct and is there any flexibility?
Thank you.
Holly

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Exactly! I’m actually laughing at the end of this article like are you kidding? How am I even gonna get my butt to go do any type of program when I can’t even get into the shower some days. Hit or miss at best.

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