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(CS)

Definition

Central sensitization (CS) is a problem of the nervous system. The nerves reset in a way that makes a child more sensitive to pain. Pain may be felt from light touch or pressure. It can also cause pain to last longer than the injury that caused it.

Causes

Changes in the spinal cord or brain cause CS. This may be from things like strokes and spinal cord injuries.

Risk Factors

Things that may raise the risk of CS are:

  • Having a health problem that causes chronic pain
  • Having a brain or spinal cord problem or injury
  • Genetics
  • The environment
  • Having mental health problems

Symptoms

Problems may be:

  • Increased reaction to things that are painful and things that are not usually painful
  • Being very tired
  • Problems sleeping
  • Changes in mood
  • Memory problems

Diagnosis

You will be asked about your child’s symptoms and health history. You will also be asked about past pain issues. A physical exam will be done. A doctor who treats pain may be needed.

No test can confirm CS. The doctor will rule out other causes of pain.

Treatment

A chronic pain plan will be needed. It will include methods to help manage pain and improve quality of life. The exact plan depends on the child’s needs. Options are:

Medicine

These medicines may help manage physical changes like inflammation:

These medicines may help manage physical changes like inflammation:

  • Over the counter pain medicine
  • Prescription pain medicine
  • Antidepressants
  • Antiseizure medicine

Therapy

Thought process, emotions, and tension can affect pain levels. Therapy may help manage pain. Options are:

Thought process, emotions, and tension can affect pain levels. Therapy may help manage pain. Options are:

  • Relaxation therapy—to ease tension
  • Cognitive behavioral therapy (CBT)—to help a child form healthy thought patterns and learn coping methods
  • Parent training—to help parents manage their child’s pain

Prevention

There are no guidelines to lower the risk of CS.

RESOURCES

American Pain Society  https://www.americanpainsociety.org 

Institute for Chronic Pain  https://www.instituteforchronicpain.org 

CANADIAN RESOURCES

Canadian Pain Society  https://www.canadianpainsociety.ca 

Health Canada  https://www.canada.ca 

References

Assessment and management of children with chronic pain. American Pain Society website. Available at: http://americanpainsociety.org/uploads/get-involved/pediatric-chronic-pain-statement.pdf. Accessed May 7, 2020.

What is central sensitization? Institute for Chronic Pain website. Available at: http://www.instituteforchronicpain.org/understanding-chronic-pain/what-is-chronic-pain/central-sensitization. Accessed May 7, 2020.

Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar;152(3 Suppl):S2-S15. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268359/. Accessed May 7, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 05/2020
  • Update Date: 05/20/2020