Central Sensitization

Definition

A neurological process in which the central nervous system becomes persistently hypersensitive, amplifying pain signals. It underlies many chronic pain conditions where normal stimuli cause pain, or where pain persists well beyond the original injury.

From injury to persistent pain: the role of neuroinflammation

In central sensitization, changes within the spinal cord and brain lower the threshold for pain perception and amplify incoming signals. This explains why people with fibromyalgia, chronic headache, or persistent back pain can experience pain in response to touch or stimuli that would not normally be painful.

Key features of central sensitization include allodynia (pain from normally non-painful stimuli), hyperalgesia (heightened pain from stimuli that are normally only mildly painful), and a spread of sensitivity beyond the original injury site.

Neuroinflammation — inflammation affecting nervous system tissues — is increasingly recognized as a driver of central sensitization. Elevated pro-inflammatory cytokines in the brain and spinal cord can alter neural signaling thresholds. This connection between inflammation and sensitization is one reason researchers are investigating whether neuromodulation approaches, including vagus nerve stimulation, might have a role in alleviating certain chronic pain conditions.

Reviewed by

Ulf Andersson

Professor of Pediatric Rheumatology, Karolinska Institutet

Worked at Karolinska for five decades as a clinician and a basic scientist focusing on inflammation. Co-discoverer of HMGB1 as the prototype alarmin molecule. Honorary doctor at Hofstra University in New York. Highly Cited Clarivate Researcher Web of Science awards.

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