You know that I'm a HUGE proponent of understanding the science of chronic pain. In fact, I think it's one of the most pivotal elements to your recovery. And guess what? In a lifetime of chronic pain, most women have yet to be given this information.

Central sensitization is something we have talked about before, and I'd like to lay it out for you in the most digestible way I know how.

1. The brain creates pain. And every time it does, the brain gets better at creating it next time around. Just like anything else we learn, our brain can learn pain. Then, pain becomes an automatic response to certain triggers - which may be jobs, social situations, certain thoughts, or events.

2. Neuroplasticity is this idea that our brain's wiring or circuitry is constantly adapting based on our experiences. This can happen in a positive OR negative direction. So while our brain can be trained to produce pain, it can also be trained to stop.

3. The body doesn't produce pain. The body sends danger messages to our brain and the brain decides what to do with those messages. The brain decides IMMEDIATELY whether it should use pain to protect you... or not. Pain is protective, but the brain can become overprotective or the alarm system overly sensitive. This process of oversensitivity, or learned pain overprotectiveness, is central sensitization.

4. You may have lingering worries about damage, injury, or that something is "broken" inside of you. I don't blame you. I'm sure your doctor showed you your images or a spine model to indicate what was "wrong". We know that most tissue injuries heal within 3-6 months and its usually an overprotective/overly sensitive nervous system that can maintain chronic pain after that. We also know that imaging abnormalities like herniated discs, bulging discs, arthritis, tears are also present in people without pain, are a normal sign of aging, and aren't always the cause of pain. We also know that people can have pain WITHOUT any injuries or damage or abnormalities on imaging. SO, the brain produces pain. Not injuries, not the body, the BRAIN.

Remember the analogy: Pain is like an overly sensitive alarm.

Pain is a wonderful and protective internal alarm system in our body that is based on our need to survive.

Pain alerts us to danger, which motivates us to take action and stay safe. It keeps us from using our arm when it’s broken, helps us reflexively remove our hand from the hot pan that is burning it, and it pushes us to take action when we accidentally cut ourselves with a knife.

For years, pain was thought of as a measure of tissue damage. We now think of pain as a complex and sophisticated protective mechanism. Think of it as an alarm system made up primarily of the brain, spinal cord, nerves, and sensory receptors or “danger detectors”. Those danger detectors are distributed all over our body and act as the eyes of the brain, which protects us. These danger detectors send messages from an affected area in your body, through the spinal cord, to the brain.

Your brain, using all of the information available to it (past experiences, memories, mood, emotions, trust, feelings of safety, input from your senses, degree of threat) will produce pain if it thinks we need to be protected.

I recently thought about this the other day when I was driving through a neighborhood in my town and someone’s home motion sensor lights were going off. My car was so far from their home, it didn’t make sense. I couldn’t see how that was helpful to them. Your pain alarm system is like a motion sensor light. The light goes off to warn you of movement near your home, a potential intruder, to get your attention. Similarly, pain will go off to let you know that something is initially wrong.

But what if those motion sensor lights were on a setting that was too sensitive, or too reactive (like my fellow neighbor’s light). They might go off when an animal walked by or when someone was driving on your street 20 feet away. There is no intruder or risk of danger to your home, just an annoying light that keeps going on and off all night long! This happens enough nights in a row that you make a note to yourself to fix it tomorrow.

Imagine that you’re finally sitting down the next day with a cup of tea, kids in bed, or you’re finally finished with errands, to watch your favorite show. And your motion sensor light goes off RIGHT BY YOUR WINDOW! Everything was peaceful, quiet, and relaxed, you don’t see anything outside. Why would this be happening right now? You’re so tired and frustration is mounting.

A sensitive alarm doesn’t care what it’s interrupting. A relaxing moment to yourself, a quiet bath, a good book, or a party.

Pain is like an alarm system. A finely-tuned alarm system.

When pain has been present for a long time, the pain alarm system can become faulty, sensitive, and too reactive as well. The threshold for danger becomes lower, and the alarm repeatedly sounds too soon. Multiple factors can contribute to an extra-sensitive alarm system, so we need to reduce threat and engage in behaviors that regulate the nervous system to recalibrate it.

What I’m saying is this: at the center of what drives continued pain, is how threatening we think the pain is.  Depending on how much threat we perceive, it will drive avoidance, depression, anxiety, distress, and more pain.  But when pain is understood to be low threat, we can escape from that loop or cycle of fear, avoidance, and pain.

You can see how Chronic pain (which is considered pain lasting 6 months or longer) is more complex than the acute pain that occurs with an injury.  Chronic pain is processed across multiple brain regions and It is associated with many changes across the nervous system.  These changes in the nervous system can cause pain to persist after injuries have healed, because the threat detection system has become more overprotective or sensitive over time.

Not all chronic pain is alike, however.  The ICD-11 recently distinguished between pain that is secondary to an injury and pain that is primary, not secondary to anything else, where the nervous system has gotten involved.  Primary pain has been called several names, the most common being nociplastic pain, central sensitization, neuroplastic pain, nonspecific pain.

If you’re thinking that your pain alarm system has become more sensitive over the years, know that it’s not your fault. It’s your brain and nervous system getting too much practice at the wrong thing, all in an effort to protect you. The good news is that you can recalibrate your pain alarm system.

Education provides the power to take the next step in managing your pain. You want to do the things you enjoy (or even basic daily activities) without flaring up your pain. For a limited time, you can grab my free video tutorial to get you started:

3 Simple Steps to a Balanced Day... Without the Flare-Ups.

This free video tutorial is dedicated to helping women with pain begin to find confidence to return to the moments, activities, and people they love the most.

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