When pain goes weird: Central sensitisation and its implications for physiotherapy practice

Information from the body is conveyed to the brain through receptors, peripheral nerves and the spinal cord. In the dorsal horn, inhibitory mechanisms under control of local, peripheral and brain influences keep sensory transmission under control. Nociceptive input from persistent inflammation and neuropathy can reduce inhibition and lead to an enhanced perception of pain. This central sensitisation is thought to underlie a number of persistent pain conditions. Physiotherapists can enhance their approaches to examination and treatment by considering the somatic tissues as well as the processing status of the sensory nervous system.