September is Pain Awareness Month, an opportunity to rethink one of our most basic assumptions about pain: that it always means something in the body is injured or damaged. What happens when an injury has healed, or there is no clear injury at all, but the pain persists? According to one neurologist, sometimes the pain itself can be the problem.
"Pain is always real, but it doesn't always mean there is ongoing damage in the body," says Dr. Anderson, Neurologist and Chief Medical Officer of Lin Health, the Denver, CO-based virtual health care company. "Sometimes, the brain and nervous system can become stuck in a persistent pain-alarm loop, continuing to send danger signals long after an injury has healed, or when there is no injury at all."
This is known as central sensitization, a condition in which the brain and nervous system amplify pain signals. It can play a major role in persistent nociplastic pain conditions, including fibromyalgia, chronic migraine, sciatica, and IBS.
"Think of it like a fire alarm that has become too sensitive," Dr. Anderson says. "That high-pitched shriek is definitely real, but it may be going off when there isn't actually a fire."
The good news, Dr. Anderson says, is that evidence-based approaches like those offered by Lin Health can help change the way the brain and nervous system process pain. "The pain is very real, and the goal is to help the nervous system become less reactive to signals that it has learned to interpret as dangerous."
This kind of brain-first approach addresses the nervous system processes that can contribute to persistent pain. At Lin Health, that approach is delivered through a medication-free virtual program combining behavioral therapy, one-on-one coaching, and structured daily modules, all delivered through an interactive app.
For Pain Awareness Month, Dr. Anderson says understanding central sensitization can be an important first step for people living with persistent pain. The pain is always real, but understanding why it persists may open the door to more effective approaches to treatment.
