Central Sensitivity Syndromes (CSS) /(FPS) / (FND)


By Dr Yunus

Central Sensitisation can be explained as problems at the level of the brain and spinal cord (CENTRAL)

A nervous system in a wired, wound up and hyper-excitable state due to the way neuro-endo-immune cells communicate chemically and through other mechanisms.  (SENSITISATION)

These sensitised cells amplify , or make stronger, messages that we get from our senses. This can cause sensory stimuli that is not normally painful, e.g. light touch, soft sound to become painful.  (Allodynia, Hyperalgesia) and amplified survival - emotional responses

Central Sensitisation is linked to Central Sensitivity Syndromes (CSS). Which are  also referred to as Functional Nerve Disorders (FND) or Functional Pain Syndromes and when more severe Environmental Illness (EI).

Central Sensitisation is known to cause and be maintained by neuroendoimmune dysregulation and alterations to core functions like liver detoxification, gut motility and digestion, and energy making. 


There are many CSS/FND conditions - fibromyalgia (persistant arthritis like muscle and joint pain) and related e.g. IBS, Overactive bladder, headaches, other.   

Until recent times CSS/FND conditions  were viewed as primarily psychological (conversion disorder, somatoform), and while the psychological components of these illness were noticed and addressed, either with punishment, reward, or therapy,  the physical symptoms complained of were often dismissed as attention seeking or hypochondrias.  (leading to in my opinion "Systemic and other Abuse")

These conditions are now known to be caused by how are genes are interacting with our  diet and lifestyle choices, and our  social and environmental exposures. (toxicants, pathogens and pollutants). When our genes and interactions are compatible, we feel well (most of the time). When they are not, we can still feel  fine most of the time  (at least for a while! but due to TDS this generally does not last!) or we can experience  Central Sensitivity Syndromes (CSS) and sometimes disease.  Often CSS is triggered when we experience a trauma usually infectious, but it can also be toxicant, chemical, physical or psychological.  When very severe, or less severe if  we are already experiencing dysregulations and changes to core functions due to a combination of factors that add up to a high total stressor load.



Examples of Central Sensitivity Syndromes?

Include those shown in the diagram below. FMS:  Fibromyalgia CFS:  Chronic Fatigue SyndromeMCSMultiple chemical sensitivity; IBS: Irritable Bowel Syndrome (IBS); Migraines PTSD:  Post Traumatic Stress Disorder;  TT: Frequent Tension Type Headaches; PMS: Premenstrual Syndroms; MPS: Myofacial Pain

This list however, is not exhaustive. For example POTS (Postural Orthostatic Tachycardia Syndrome), which many people with ME/CFS experience can also be considered a CSS.

Diagram by Dr Yunus
Picture source:fibromyalgia and overlapping disorders by Dr Yunus


It is not uncommon for people to develop many CSS, usually over a period of time (time dependant sensitisation) but sometimes very quickly (genetics, trauma).   This is why some people can experience lots of different symptoms. Up to 50 SYMPTOMS sometimes more!  

Fortunately these symptoms are not generally experienced all at once, except in rare cases (the Universal Reactor), instead they tend to wax and wane, depending on what is going in inside the body (e.g. hormone fluctuations) and exposures outside the body (e.g. weather, activity, pollutant and toxicant exposures, food intolerance).

While CSS/FNS - FND tends to respond poorly to pharmaceutical interventions, people can usually reduce symptoms and sometimes recover completely with non pharmaceutical interventions (Integrative self management)  and proper medical treatments for any co morbid health conditions they have. 


When severe applied within a REST, REDUCE, PACE is best, based on my own experience. 


Diagnoses, Self-diagnoses, and Symptoms that May Suggest Central Sensitization Syndrome (Especially If Copious)
Abdominal bloating Abdominal pain, chronic abdominal pain Adrenal insufficiency (self-diagnosed), adrenal fatigue Alopecia, hair loss, trichotillomania Anxiety Atypical facial pain Atypical or non-cardiac chest pain Autoimmune disorder (self-diagnosed) Autonomic disorder (self-diagnosed) Black mold, toxic black mold (self-diagnosed) Brain fog, fibrofog Burning mouth syndrome Burning tongue Candida or chronic yeast infection Chiari malformation Chronic low-back pain Chronic non-specific lightheadedness Chronic pain Chronic pelvic pain Chronic prostatitis Chronic tension or migraine headaches Chronic testicular or scrotal pain Chronic whiplash-associated disorders Chronic widespread pain Complex regional pain syndrome Delusions of parasitosis Depression or bipolar disorder Dizziness Edema or swelling complaints not evident on examination Ehlers–Danlos syndrome Fatigue or chronic fatigue Fibromyalgia, myalgic encephalitis Hormone imbalance Hyperventilation Hypoglycemia (self-diagnosed) Immune deficiency (self-diagnosed) Interstitial cystitis, painful bladder syndrome Irritable bowel syndrome Joint pains Low testosterone or hypogonadism (with normal test results) Lupus (self-diagnosed) Lyme disease, chronic Lyme disease (self-diagnosed) Meniere disease Morgellons disease (self-diagnosed) Multiple chemical sensitivities Multiple drug allergies or intolerances (self-diagnosed) Multiple food allergies or intolerances (self-diagnosed) Myofascial pain syndrome Palpitations Panic disorder, episodes, attacks Pelvic pain, chronic pelvic pain, premenstrual syndrome Polycystic ovary syndrome Porphyria (self-diagnosed) Post-deployment syndrome Post-traumatic stress disorder Postural orthostatic tachycardia syndrome (POTS) Pseudotumor cerebri Schamberg disease, soft tissue tumors Sick building syndrome Sjögren syndrome (blamed for multiple symptoms) Temporomandibular disorders, temporomandibular joint pain Thyroid disease (with normal test results, usually self-diagnosed) Tinnitus Vulvodynia, vulvar vestibulitis [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422459/]






For list of scientific and medical articles on Central Sensitivity Syndromes click here 

Fibromyalgia and Overlapping Disorders: The Unifying Concept of Central Sensitivity Syndromes by Dr Yunus to read [Click Here] to read.

Pain Res Treat. 2012; 2012: 584573.
Published online 2011 Nov 17. doi: 10.1155/2012/584573
PMCID: PMC3236313
The Prevalence of Fibromyalgia in Other Chronic Pain Conditions
Muhammad B. Yunus *

Central Sensitivity Syndrome http://www.bcwomens.ca/Professional-Resources-site/Documents/Central%20Sensitivity%20Syndromes%20(CSS)%20one%20page%20summary.pdf






This Post Has Been Viewed 17,638 Times