Neurophysiology · functional reading

Central sensitization

Central sensitization refers to an amplification of the central nervous system's response to sensory signals: pain can then be more intense, more widespread or longer-lasting than the state of the tissues would suggest.

Scientific basis

Described notably by Clifford Woolf, central sensitization corresponds to an increase in the excitability of the neurons of the spinal cord and brain involved in pain.

It can result in: pain provoked by stimuli that are usually not painful, such as simple pressure; an exaggerated response to a painful stimulus; an expansion of the painful area; persistence of pain after the initial cause has disappeared.

It is one of the mechanisms discussed in chronic pain, including some forms of chronic low back pain. Since 2017, the IASP has also used the term nociplastic pain to designate pain arising from altered nociception without an identified lesion.

Blue Portance / SBNFA™ reading

The SBNFA™ places its analysis on the side of the conditions in which the nervous system operates, without taking the place of an assessment of the pain mechanism. It distinguishes between the neurophysiological mechanism of pain and the mechanical and sensory conditions in which the body finds itself.

In the SBNFA™ framework, micro-movements feed a continuous sensory loop: movement, mechanical information, adjustment. The SBNFA™ puts forward the hypothesis that preserving opportunities for adjustment sustains a greater diversity of mechanosensory information than a strictly fixed position. The clinical relevance of this hypothesis in people with central sensitization has yet to be established.

Contribution to the analysis of sitting

In a sensitized person, the simple pressure of the seat or holding a position for a long time can become painful. Observing tolerance to duration, to the location of support points and to their variability provides functional information, but does not establish the presence of central sensitization.

Not to be confused with

Neuropathic pain, caused by a lesion or disease of the somatosensory system; nociceptive pain, caused by the activation of nociceptors by tissue damage; peripheral sensitization, which involves the nerve endings.

Sources and scope

An established neurophysiological mechanism; its clinical identification in a given patient remains debated. This entry does not replace a medical evaluation.