Central Sensitisation and Nociplastic Pain

There are three main types of pain which create different symptoms:

• Nociceptive pain - pain from an injured body structure, often in a consistent area, aggravated by the same movements and eased when movement stops or is not in a straining direction. Nociceptive pain often responds well to anti-inflammatory medication and resolves within the normal healing time-frame of 6-12 weeks.
• Neuropathic pain - pain from damage to a nerve structure, characterised by unremitting pain in consistently the same area, often with tingling, burning or even random electrical shock sensations (ectopic firing), sometimes muscle weakness and numbness, and usually not responsive to anti-inflammatory medication.
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• Nociplastic pain - This is pain which is not necessarily consistently in the same place, is not necessarily related to actual tissue damage (because the original damage heals within 3 months), is not always responsive to anti-inflammatory medication and is accompanied by many other strange or seemingly unexplained symptoms. Unexplained symptoms may be gut-related symptoms, limb 'heaviness', sensitivity to light / sound / taste / smell, pains in multiple body areas, poor sleep, poor attention and concentration, 'brain fog', sensations of sensory overload, among others.

Nociplastic pain can be driven by a mechanism called central sensitisation. Central sensitisation is an increase in sensitivity of various senses and to pain sensations so that the patient feels many more sensations from their body than they normally would. The patient would normally filter out many bodily symptoms as the brain ignores irrelevant sensations, but with central sensitisation this filtering mechanism is diminished. Consequently, they may perceive many more sensations than they used to, some of which are painful. The filtering mechanism is likely to be diminished further when they are stressed, anxious or haven't slept well for a few nights, thereby increasing their symptoms even more.

The focus here is to retrain the brain primarily, not the damaged muscles/ligaments etc.. This is very important to understand.

_{click here to see short video}

Helpful short videos links about pain:

https://www.youtube.com/watch?v=jIwn9rC3rOI

https://www.youtube.com/watch?v=cLWntMDgFcs