Central sensitisation is a term used in pain science to describe a nervous system that has become more reactive. It is not a sign that you are weak, broken, or imagining symptoms. It is a description of a system that has learned to stay in protection mode.
When the system is sensitised, sensations can feel louder than they “should”, and symptoms can linger long after the original trigger has passed. This often explains why pain continues even when scans look reassuring or an injury has healed.
What central sensitisation actually means
In simple terms, the brain and spinal cord become better at producing pain and other protective symptoms. The threshold for “danger” drops, and the volume of the alarm goes up.
- Normal sensations can register as threatening.
- Pain can spread or move, even without new damage.
- Symptoms can persist because the system expects them.
- Stress, poor sleep, and overload can amplify everything.
Importantly, sensitisation is about processing, not pretending. Pain remains a real body experience; it is simply being generated or amplified by a protective nervous system.
How sensitisation develops
Sensitisation often starts for sensible reasons. It can follow an injury, illness, surgery, a period of intense stress, or a long stretch of uncertainty about symptoms. The nervous system adapts to protect you, then struggles to switch off.
Common contributors include:
- ongoing fear of damage, re-injury, or “something being missed”
- pain-focused monitoring, checking, and constant scanning
- repeated flare-ups that reinforce the expectation of danger
- sleep disruption and fatigue
- past trauma, medical trauma, or prolonged life pressure
- mixed or frightening messages about your body
Signs sensitisation may be involved
Central sensitisation can look different for different people. It is not a diagnosis on its own, but a useful framework. Patterns that often point towards sensitisation include:
- pain that spreads, moves, or changes quality over time
- symptoms that flare with stress, conflict, uncertainty, or poor sleep
- high sensitivity to touch, movement, sound, light, or fatigue
- pain that feels disproportionate to what you are doing physically
- reassuring tests, yet ongoing symptoms and fear
These clues do not replace medical advice. They simply suggest that the nervous system may be a major part of the picture, and therefore a key place to focus recovery efforts.
What helps a sensitised system calm down
The aim is not to “convince yourself” nothing is wrong. The aim is to give the brain and body repeated evidence of safety, so the alarm settings can reset.
That often includes:
- Pain education - learning a clearer, less frightening explanation of symptoms
- Nervous system regulation - breathing, grounding, and downshifting activation
- Graded exposure - returning to movement and life in manageable steps
- Reducing monitoring - less checking, less threat-scanning
- Working with stress and emotional load - not as blame, but as biology
In many cases, the most powerful shift is moving from “What if this means damage?” to “My system is reactive, and it can learn safety again.”
A realistic expectation
Sensitisation usually builds over time, so it usually unwinds over time too. Progress often looks like fewer spikes, quicker recovery, less fear, and a wider life - even before symptoms reduce dramatically.
If you keep building safety, the nervous system often follows. Not perfectly, not overnight, but steadily.