Skip to content
Wellness & Prevention

Chronic Pain in Fibromyalgia: The Role of Central Sensitization

4.1 (75 votes)
Chronic Pain in Fibromyalgia: The Role of Central Sensitization
Text size:

One of the most frustrating aspects of fibromyalgia is the widespread and seemingly inexplicable pain. There is no inflamed joint, there is no fracture, yet the pain is real, intense, and constant. To understand this phenomenon, we need to look at how the nervous system processes pain signals.

How Pain Perception Works

Under normal conditions, when a tissue is damaged, pain receptors (nociceptors) send electrical signals to the spinal cord, which filters them before transmitting them to the brain. Only the most relevant signals pass through these spinal filters and reach our consciousness as the sensation of pain.

This filtering system is crucial: if every micro-stimulus reached the brain, we would be constantly overwhelmed by painful sensations coming from every part of the body.

When Filters Break Down

In fibromyalgia, this filtering mechanism becomes dysfunctional. The neurons in the spinal cord, subjected to prolonged or repeated stimulation, enter a state of hyperexcitability: their activation threshold drops drastically. The result is that normally harmless stimuli — such as light pressure, contact with clothing, or a hug — are interpreted as painful.

The Short-Circuit Phenomenon

A particularly relevant aspect is the ability of peripheral nerves to store stimuli of various natures and intensities. A blow, a trauma, an infection can leave a trace in the nervous system that persists long after the original damage has healed. This neuronal short-circuit can remain active for years, fueling chronic pain.

Global Sensory Hypersensitivity

In fibromyalgia syndrome, all sensory systems can become overexcited:

  • Touch: light stimuli perceived as painful (allodynia)
  • Hearing: hypersensitivity to sounds
  • Smell: normal odors perceived as unpleasant or intense
  • Sight: discomfort from bright lights
  • Taste: aversion to certain flavors

This generalized hypersensitivity confirms that the problem does not lie in the individual sensory organs, but in the way the central nervous system processes all sensory information.

The Good News

The nervous system is plastic, meaning it can change. Just as it has learned to amplify signals, it can learn to regulate them again. Approaches that work on reducing sensory overload and restoring spinal inhibitory mechanisms can lead to significant improvements in pain.

Sources & scientific references (5)

Comments 4

comments.cta_title

comments.cta_text

comments.login_cta

D
Diego Orlando
L'approccio alla sensibilizzazione centrale è davvero la chiave per comprendere il dolore nella fibromialgia. Non è un dolore immaginario, ma un'amplificazione reale dei segnali dolorosi da parte del sistema nervoso. Grazie per averlo spiegato in modo così chiaro e accessibile.
R
Roberto Monti
Assolutamente d'accordo. Quando il mio medico di base mi ha detto che era tutto nella mia testa, ho cambiato medico. Quello nuovo conosceva la sensibilizzazione centrale e finalmente mi sono sentita ascoltata e compresa.
S
Silvia Marino
Questo articolo dovrebbe essere letto da tutti i medici di base. Troppo spesso il dolore cronico viene liquidato come problema psicosomatico, quando in realtà ha basi neurofisiologiche ben documentate dalla letteratura scientifica.
S
Silvia Palumbo
La TENS mi ha aiutato molto nella gestione del dolore cronico. Non elimina il dolore completamente, ma lo rende più sopportabile nei momenti peggiori. Associata alla terapia farmacologica e al movimento dolce, fa parte del mio kit di sopravvivenza quotidiano.