Central Sensitization

When the scans look “normal,” treatments stall, and your symptoms feel out of proportion to the trigger, the nervous system may be amplifying pain signals.
central sensitization

The Clinical Reality

Central sensitization is best understood as an amplification problem in pain processing. The nervous system becomes more reactive and less precise, so normal input can register as threat and minor input can feel intense. This does not mean the pain is “in your head.” It means the gain is turned up.

In practice, central sensitization often develops when peripheral drivers repeatedly irritate or overload the system. Examples include persistent muscle guarding, tendon irritation, joint shear, nerve sensitivity, pelvic floor overactivity, or a cycle of flare and crash. Over time, the brain and spinal cord learn the pattern and start predicting danger early, widening the sensitivity map and lowering your tolerance for load, stress, and sensory input.

Our clinical focus is twofold: reduce the overall sensitivity of the system and identify the specific peripheral inputs that keep feeding it. When those drivers are found and treated, symptoms often become more predictable and your capacity can be rebuilt with fewer setbacks.

Why Standard Care Fails

Standard care often separates the problem into either structural damage (find it on imaging, fix it surgically) or chemical modulation (reduce symptoms with medication). Central sensitization frequently sits in the gap between those models.

  • Imaging can be non-explanatory because sensitization is a processing problem, not always a visible tissue lesion.
  • Medications may reduce intensity but rarely address the ongoing peripheral inputs from myofascial trigger points, tendon load intolerance, or nerve irritation that keep the system on alert.
  • Rehab programs can fail when they progress load too aggressively or do not account for flare mechanics, leading to repeated sensitization cycles.
  • Patients get labeled as “chronic pain” without a hands-on map of which tissues and nerves are still contributing.

Our role is not to replace medical care. It is to provide an assessment-driven, hands-on plan that targets functional drivers and rebuilds load tolerance using pacing and neuromodulation strategies.

Signs & Symptoms

Do any of these sound familiar?

Pain that spreads or changes location

Symptoms may migrate, feel diffuse, or “light up” regions beyond the original injury, especially during stress, poor sleep, or workload spikes.

Allodynia and sensory sensitivity

Normal inputs such as clothing seams, light touch, sitting pressure, temperature shifts, or screen time can feel irritating or painful.

Disproportionate flares after activity

A workout, travel day, or long meeting can trigger a delayed flare 12 to 48 hours later, with symptoms lasting longer than expected for the activity.

Muscle guarding and “protective tension”

Tightness feels involuntary and persistent, often with tender bands or trigger points that refer pain and reproduce familiar symptoms on palpation.

Nerve-type pain patterns

Burning, buzzing, electric sensations, tingling, or “hot spots” that track along a nerve corridor and worsen with stretch, compression, or sustained postures.

Root Cause Contributors

The mechanical drivers behind your symptoms

Myofascial trigger points and regional hypertonicity

Persistent tender points and guarding can act as a continuous nociceptive input, reinforcing amplification and limiting movement options.

Peripheral nerve mechanosensitivity

Irritable nerves can become sensitive to glide, compression, and tension, creating sharp or burning symptoms that prime the system for over-protection.

Tendon and enthesis load intolerance

Low-grade overload at tendon attachments can be missed on imaging yet repeatedly re-triggers symptoms when training volume or posture demands increase.

Pelvic floor overactivity and coordination deficits

In pelvic pain patterns, elevated tone and poor down-training can maintain threat signaling and contribute to urinary, bowel, or sexual symptom flares.

What to Expect

Your roadmap to recovery
Weeks 1 to 2
Clearer map of your triggers and drivers, an initial pacing baseline, and early reduction in flare volatility for some patients.
Weeks 3 to 6
More predictable symptoms, improved tolerance for key activities (workdays, training elements, sitting or travel), and fewer multi-day rebounds when pacing is followed.
Weeks 7 to 12
Capacity-building focus with graded load progression, improved recovery after stressors, and a practical maintenance plan for higher-demand weeks.

Frequently Asked Questions

Get answers to common questions

It is primarily a clinical pattern describing amplified pain processing and reduced tolerance to input. Many people also have identifiable peripheral drivers contributing to that amplification. Our job is to assess both the “volume knob” and the inputs that keep it turned up.

No. Imaging and labs are essential for ruling out medical pathology, but they often do not capture muscle guarding, tendon load intolerance, nerve mechanosensitivity, or coordination problems. Those functional findings can be assessed directly with a hands-on exam and provocation testing.

They are used as neuromodulatory and local tissue inputs. Clinically, we use them to reduce protective tone, calm sensitized trigger points, and address nerve-adjacent irritability. The goal is not a one-time “reset,” but improved signal quality so graded activity can be tolerated.

Some people experience temporary post-treatment soreness or a short-lived symptom increase, especially early on. We plan around your sensitivity level, adjust dosage, and use pacing so the overall trend is improved predictability and tolerance rather than repeated crashes.

Frequency depends on irritability and complexity. Many patients start with 1 to 2 visits per week for a short period, then taper as symptoms stabilize and capacity improves. We set a plan based on your response, schedule, and goals.

New progressive weakness, loss of bowel or bladder control, saddle anesthesia, fever, unexplained weight loss, night pain that is rapidly worsening, recent significant trauma, or suspicion of infection or fracture should be evaluated urgently by the appropriate medical provider or emergency services.

Ready to Find Real Answers?

Schedule a free 15-minute discovery call to discuss your case and determine if our approach is right for you.

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118 W. 72nd, Rear Lobby, Upper West Side, NY 10023 Evidence-based acupuncture and dry needling on the Upper West Side, NYC. From chronic pain, headaches, and pelvic floor dysfunction, Dr. Jordan Barber integrates the highest level of training with compassionate care to help you thrive. Disclaimer: This site does not provide medical advice. Always consult a qualified healthcare professional before making changes to your health. Read our full disclaimer

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