Central pain sensitization is the primary cause of chronic pain. It is a central nervous system phenomenon. Theory's of pain that only take into account the peripheral nervous system fail to explain an guide treatment of chronic hernia mesh pain. The clinical components of central pain are very confusing to patients and can confuse clinicians.
Painful stimulus over some period of time is a cause of Central Pain Sensitization. I do not have data on this but it is my suspicion that the longer the inciting painful stimulus lasts the harder it is to treat sensitization. This why I think it is a mistake to wait too long to remove hernia mesh causing chronic pain.