Fibromyalgia/Chronic Pain Syndromes
Chronic pain syndromes: Central Sensitisation
There is currently a lot of interest into the concept of chronic pain and chronic pain syndromes. We know that not all patients who experience back pain for the first time will develop into a chronic pain syndrome however we do know there are risk factors that we can identify that may be contributing factors such as a history of depression or anxiety or even poor job satisfaction. Chronic pain syndromes however are a different story and many chiropractors believe these syndromes are not a mechanically based complaint but a neurological. This means the central nervous system is 'over wired' and becomes highly sensitive to any stimulus, sometimes even touch. We call this Central Sensitisation. Patients who have this 'sensitive wiring' are usually highly receptive to certain treatments and can feel worse after a therapy, especially one that might be considered more 'rough'. Generally these patients may doctor shop around trying to find the one and only therapy that may 'cure' their pain. However we know that this vicious cycle often compounds their pain experience. So how do we identify if a patient has this 'central sensitisation'? Unfortunately there is no one clinical test we can use to identify central sensitisation however we do have a questionnaire called the CSI which may identify the risk. If Niki asks you to complete the questionnaire, she will advise you of the score and likelihood of your complaint been compounded by a highly sensitive central nervous system. If deemed likely, Niki will usually wind back her treatment to a 'less is more' approach to Chiropractic care. This aims to recalibrate the CNS by reducing the pain stimulus (avoidance), and assisting to downplay. The second stage of care is to introduce exercises which are localised to induce mild discomfort but not pain. This will induce a change in the way your brain perceives a stimulus. Niki will also look into the emotional aspect of pain such as stressors, and if needed, can recommend a practitioner who may be able to assist in the cognitive aspect of your pain. Some examples of clinical syndromes that central sensitization may contribute are: - patello-femoral pain syndrome - Osteoarthritis - Rheumatoid Arthritis - Temporomandibular Disorders - Fibromyalgia - Chronic neck pain from Whiplash -CRPS - neuropathic and post surgical pain If you would like to discuss your complaint with Niki, please call her directly on 0434 059 242. 'Sensitisation in chronic pain: pain itself can change how pain works' Paul Ingram Mar 29,2019. www.painscience.com/articles 'Central sensitisation: Implications for the diagnosis and treatment of pain' Clifford Woolf. PMC. Mar 2011; 152(3) S2-15. www.ncbi.nlm.gov/pmc/articles/PMC4268359
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