Updates & Features

Central Sensitisation: From Physical Examination To Clinical Significance

July 2019

Dr Emilio Quetglas, The PainSolve Team


One of the mechanisms used to describe the genesis of chronic pain is peripheral sensitisation. This constitutes a decreased threshold and increased responsiveness of nociceptors due to post-translational changes in, and altered trafficking of, transducer receptors and ion channels. Clinincal characteristics of peripheral clinical pain are pain after the end of a stimulus and a spread of sensitivity to normal tissue induced by local inflammatory mediators. This is referred to as the zone of primary hyperalgesia.1

In contrast, in chronic neuropathic pain the mechanically sensitive skin area often extends beyond the area of the initially involved root or nerve to create a zone of secondary hyperalgesia. This area is unaffected by the primary nerve lesion, which often becomes independent of the initial noxious event.


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