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Dynamic Quantitative Sensory Testing to Characterize Central Pain Processing
Published on: February 16, 2017
[Explanation of central sensitisation to patients with medically unexplained symptoms helps acceptation]
Carine den Boer1,2, Berend Terluin1, C Paul van Wilgen3
1Amsterdam AMC, locatie VUmc, afd. Huisartsgeneeskunde, Amsterdam.
Abstract:
Doctors and patients are often not satisfied about the treatment of medically unexplained symptoms (MUS) and chronic pain. Central sensitization (CS) plays an important role in chronic pain and regularly also in MUS and can be used for explanation to these patients. This explanation can cause acceptance and understanding, leading to cessation of further diagnostics and unnecessary treatments. Thereafter the patient will be able to work on reduction of the symptoms, using the biopsychosocial model. The central mechanism of CS is hyperexcitability of the central nervous system. The most important symptoms of CS are: (a) an increased sensitivity to painful stimuli (hyperalgesia), (b) a painful perception of non-painful stimuli (allodynia) and (c) a reduced inhibition of signals from the brain to the body. This can be demonstrated with physical tests. CS can be explained to the patient with a simple model about the functioning of the nervous system.
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