I read the other day on social media a suggestion for patients when selecting a healthcare provider to ask them their definition of pain to see if it is similar to the definition provided by the International Association of the Study of Pain (IASP).

Interesting idea.

The key for me is if they understand pain is biopsychosocial (BPS) in nature and treat it that way.

I may have to ask this going forward. What do you think?

Related information

• IASP definition of pain

• Are You Missing Two-Thirds of Your Potential Pain Treatment Plan? (My article about BPS)

• Think Pain Is Purely Medical? Think Again. (An article from Dr. Rachel Zoffness)

• 23 Tips to Help Get the Best Chronic Pain Treatment from Your Doctor (My article with input from my Chronic Pain Champions - No Whining Allowed Facebook support group)

We’re more than our bodies. Yet, we’ve been typically treating chronic pain only from a biological perspective – potentially missing two-thirds of potential pain treatment.

Enter the biopsychosocial (BPS) model introduced by Dr. George Engel in 1977.

This model of medicine stresses a holistic look at the experience of chronic pain. It not only looks at the biological factors (injury, tissue damage, etc.) but also how our emotional well-being and our social situation influence how we’re affected by chronic pain.

Learn more about the biopsychosocial model:

• Are You Missing Two-Thirds of Your Potential Pain Treatment Plan? (my article)
• Think Pain Is Purely Medical? Think Again. 
• My BPS example
• Biopsychosocial questions to ask yourself
• The Biopsychosocial Approach
• The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry
• The role of psychosocial processes in the development and maintenance of chronic pain disorders
• The biopsychosocial approach and considerations involved in chronic pain
• The Essence of Biopsychosocial Model From 17th to 20th Century Science (Dr. Engel)
• My Time at the Mayo Clinic Pain Rehabilitation Center
  

[Updated 11/18/21]

If you have chronic pain, the answer is probably yes.
 
Central sensitization has been tied to a variety of chronic pain conditions including fibromyalgia, whiplash, shoulder pain, neuropathic pain, chronic fatigue syndrome, non-cardiac chest pain, irritable bowel syndrome, temporomandibular disorders, complex regional pain syndrome, low back pain, osteoarthritis, pelvic pain, and headache. 
 
What is it
Central sensitization, also called centralized pain, is due to maladaptive neuroplastic changes in the spinal cord and brain. And is associated with the development, maintenance, and amplification of chronic pain.  
 
The official definition by the International Association for the Study of Pain is, “Increased responsiveness of nociceptive neurons in the central nervous system to their normal or subthreshold afferent input.”
 
Understanding it - putting it in plain language
Chronic pain is an abnormal response and doesn’t improve over time.  It can happen long after an injury or illness heals.  It can be due to a degenerative disease, like arthritis.  It can be neurological.  It can also have no known biological cause, as in the case of fibromyalgia and many common low back pain conditions.
 
Once it becomes chronic, pain loses its warning function and becomes its own disease/condition. It changes how the brain processes pain – misfiring nerve signals and continuing to tell the body it hurts.  Just like an alarm that goes on and won’t turn off. An overreaction or amplification, of sorts. It gets stuck on high alert and the body learns the pain.
 
And it can happen in all chronic pain conditions, no matter the underlying cause. We may feel it when only lightly touched or bumped.  The pain can move around to different areas of the body other than the spot of the original injury.  It can even change the type of feeling we may have like achiness, stabbing, tingling, or burning, for example.
 
Changing it
The good news is we can change our nervous system.  Central sensitization can be reversed by doing things that promote positive neuroplasticity like changing how we think about pain, react to pain, and manage pain.
 
Best treatment is a biopsychosocial approach, including pain education, physical therapy, cognitive behavioral therapy, pain acceptance, sleep management, and pharmaceutical management.  I got a heavy dose of all these at the Mayo Clinic Pain Rehabilitation Center.
 
Learn more

• Dr. Sletten Discussing Central Sensitization Syndrome – A descriptive and easy-to-understand video from the Mayo Clinic. 
• How to desensitize the brain and eliminate chronic pain caused by central sensitization - A comprehensive helpful video from Dr. Andrea Furlan.
• What is Central Sensitization? – A great read from the Institute of Chronic Pain.
• Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity – A more detailed journal article.​
• Neuroplasticity – A helpful video and easy-to-read information from painHealth.
• My Time at the Mayo Clinic Pain Rehabilitation Center – An article I wrote for Practical Pain Management about my experience at the Mayo pain program.

Self-management calming tools 

• Mindful Breathing (Mayo Clinic)
• ​Passive Muscle Relaxation to Manage Anxiety and Stress (12:40)
• Progressive Muscle Relaxation to Manage Anxiety and Stress (15:00)
• Find more here

You could me missing out on two-thirds of your potential pain treatment. Get the whole story.