Central Pain Sensitization

Chronic Hernia Mesh Pain

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.

Clinical components of Central Pain Sensitization 
  • Widening of The Pain Field: Pain is perceived as coming from other areas of the body that are not receiving a pain stimulus. This happens because the pain pathways, that are normally anatomically oriented, cross link with different anatomical pain pathways.
  • Hyperesthesia: This is when a relatively minor pain stimuli causes extreme pain. Synapses in the pain pathways become enhanced amplifying the perception of pain.
  • Allodynia: Touch stimulus causes pain. This happens because central nervous system pain pathways and touch pathways become cross connected. So, a touch stimulus gets rerouted to the pain pathways. 

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.

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