Central sensitisation is a term used in pain neuroscience to describe a state in which the central nervous system, specifically the brain and spinal cord, has become abnormally amplified in its processing of pain signals. It is the mechanism behind many chronic pain conditions that resist conventional treatment, including fibromyalgia, chronic widespread pain, and some presentations of low back pain, neck pain, and headache.

Understanding central sensitisation matters because it reframes the question of treatment. When pain is driven by a sensitised central nervous system, addressing only the peripheral tissue is addressing the wrong level of the system.

How Central Sensitisation Develops

Central sensitisation typically develops in response to sustained peripheral pain input. In the early stages of an injury or painful condition, the nervous system is processing normal nociceptive signals from the damaged or irritated tissue. As that input continues over weeks and months, the nervous system adapts.

The adaptations occur at multiple levels. At the spinal cord, synaptic connections in the pain pathways become more efficient, a process called long-term potentiation. Inhibitory interneurons that normally suppress pain signals become less effective. At the brain level, areas involved in pain modulation show reduced activity, while areas involved in pain amplification show increased activity. The overall effect is a nervous system that is progressively more sensitive to incoming signals and less capable of moderating its own pain response.

At this stage the pain is no longer a proportional response to peripheral tissue damage. It is being generated and amplified by the nervous system itself, in response to stimuli that would not previously have produced pain. This is why people with central sensitisation often experience pain from light touch, temperature changes, or activities that would be unremarkable for someone without the condition.

Conditions Associated with Central Sensitisation

Central sensitisation is considered a significant factor in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, temporomandibular joint disorder, tension-type headache, and chronic low back pain. It is also implicated in whiplash-associated disorder and in some post-surgical pain presentations.

The common thread is persistent pain that is disproportionate to identifiable tissue damage and that involves widespread sensitivity beyond the original pain site.

What Helps and What Does Not

Strong mechanical input, whether deep tissue massage, high-velocity manipulation, or aggressive exercise, typically worsens central sensitisation. The sensitised nervous system interprets strong input as a threat and responds by amplifying its defensive response. This is why many people with fibromyalgia or chronic widespread pain have had their symptoms worsened by well-intentioned treatment.

Approaches that reduce peripheral input without threatening the system, support parasympathetic activation, and work incrementally with the nervous system’s own regulatory capacity are more appropriate. Body Stress Release is designed around these principles. The input is light, the approach is guided by the body’s responses, and the process works with the nervous system rather than against it.

Peter van Minnen has worked with many patients whose pain has a significant central sensitisation component. Progress is gradual, but the cumulative reduction in peripheral load and the support for nervous system downregulation that BSR provides can meaningfully reduce overall pain levels over time.

For those looking at the broader context, our article on chronic pain and the nervous system explains the full picture of how the nervous system is involved in chronic pain beyond central sensitisation specifically.

If your pain fits the pattern of central sensitisation and previous treatment has made it worse, contact us to speak with Peter van Minnen at Hever Health about a gentler approach.