Pain that has no physical basis (no underlying tissue damage, inflammation, etc.) or that appears more painful than is warranted based on objective findings, is often referred to as “Central Sensitization Pain”1
Pain can be present even if there is no tissue damage, and pain can persist even after tissues heal from an injury. Your brain can create, amplify or diminish your experience of pain. This doesn’t mean that your pain is not real. All pain is real, and all pain exists only in the brain.
Central Sensitization Pain arises when the central nervous system becomes hypersensitive, interpreting otherwise normal stimuli as pain. In fact, the brain can even “feel” pain in tissues or limbs that no longer exist – a surprisingly common occurrence in amputated limbs (“phantom limb syndrome”). Treating hypersensitivity therefore requires a different approach than treating a physical injury.
If your chronic pain is not rooted in a musculoskeletal problem, or if the underlying injury has not healed, classic orthopaedic physiotherapy is not indicated as it is not likely to be effective long-term. Instead, chronic pain treatment focuses on desensitizing the nervous system using a whole-body approach that involves education, physical activity, behavioural therapy, and various patient-specific interventions.
Nervous system desensitization can retrain the brain to respond to sensation in a more measured way, and is the preferred strategy for treating conditions such as Fibromyalgia or Complex Regional Pain Syndrome.
If you are interested in participating in an optional 6-week program for treating chronic pain arising from hypersensitivity, I can help guide you through a structured step-by-step homework-based program that includes patient workbook, videos, and weekly follow-up visits.
- Latremoliere A., Woolf C.J. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009 Sept;10(9):895.926. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750819/