Health Topics

The importance of proper examination in diagnosing Central Sensitization Syndromes

Patients with CSSs present a response to everyday stimuli that is often perceived as exaggerated. Furthermore, their discomfort does not have an obvious bodily cause. In many cases, the characteristics of this syndrome make a correct diagnosis difficult.

Central Sensitization Syndromes (CSSs) are a heterogeneous group that includes more than 50 illnesses. Some of them are Fibromyalgia, Chronic Fatigue or Multiple Chemical Sensitivity, amongst others, and the risk factors are widely unknown.

CSSs, in part, share a common pathogenic mechanism, although each one of them has their own characteristics and criteria for definition. For example, beyond the most widely known illnesses such as Fibromyalgia, there are other disorders such as tension headache and irritable bowel syndrome in which there is a sensitization to certain stimuli, in these cases, to situations of stress or consuming certain foods.

Other common features are the presence of psychological disorders and the presence of severe pain which, when a radiological test is done on the affected area, has no apparent cause. It is also important to determine whether the patient’s symptoms have a duration which could be considered chronic (longer than six months) and whether they significantly affect their daily activity and quality of life.

On many occasions, all these features lead health professionals to suspect that the symptoms are due to somatization (a mental disorder that causes bodily symptoms) or an addiction to certain medications (opioids and painkillers). The key to correctly diagnosing these illnesses is proper examination and an exhaustive interview with the patient as, for now, there is no confirmatory analytical test available for most CSSs. Proper interpretation of prior clinical history is also essential. In this way, these syndromes can be detected and not confused with something else.

Central Sensitization Mechanism

Central Sensitization illnesses have been grouped together because they share pathological mechanisms. In this case, the illness develops from the same alteration to the nervous system, which is known as Central Sensitization (CS). CS consists of having a much higher than normal cerebral response to everyday stimuli such as noise, light, physical contact, physical activity or changes in the immediate environment. Sensitivity is the ability to detect stimuli and react to them, whereas sensitization is the progressive increase in the response to a repeated stimulus. This sensitization makes the affected person much more bothered by certain stimuli and this disorder significantly interferes with their everyday life.