What Is Central Sensitization? A New Understanding of Chronic Pain and Fatigue
For those living with ME/CFS, long COVID, fibromyalgia, or persistent pain, the experience often feels invisible and misunderstood. Despite normal scans or bloodwork, the symptoms are very real: pain, fatigue, brain fog, sensory overload, and more. One of the leading frameworks to understand these conditions is something called central sensitization, now more accurately referred to as nociplastic pain.
But what does that actually mean and how can this knowledge support healing?
What Is Central Sensitization (Nociplastic Conditions)?
Central sensitization describes a state where the central nervous system (brain and spinal cord) becomes overly sensitive to stimuli. It’s like the body’s alarm system has been dialed up, sometimes way up.
Even though the original injury, infection, or stressor may have resolved, the nervous system keeps reacting as if there is ongoing danger. Everyday input such as light, sound, movement, touch, even emotions can trigger exaggerated pain, fatigue, or distress responses.
In 2017, the International Association for the Study of Pain introduced the term nociplastic pain to better reflect what’s happening:
“Noci” = related to nociceptors (pain sensors)
“Plastic” = changeable, shaped by experience and neuroplasticity
So, nociplastic pain refers to pain arising from altered pain processing, not tissue damage, inflammation, or structural injury.
How Does This Show Up in Conditions Like ME/CFS, Long COVID, and Fibromyalgia?
In these conditions, many symptoms can be explained by this “sensitized” nervous system:
Pain without obvious physical injury
Extreme fatigue after small exertion (post-exertional malaise)
Cognitive fog from sensory or emotional overload
Light, sound, and touch sensitivities
Fluctuating symptoms based on stress, sleep, hormones, or immune triggers
In ME/CFS and long COVID, research suggests there is a dysregulation in how the brain and body communicate, especially in areas that govern energy production, immune signaling, and stress response. This results in a body that feels unsafe, depleted, and reactive—even without external threats.
What Causes the Nervous System to Become Sensitized?
Sensitization doesn’t happen overnight. It’s usually the result of multiple hits to the system, such as:
Viral or bacterial infections
Repeated physical or emotional stress
Head injuries or trauma
Environmental toxicity or mold
Early life adversity or attachment wounds
Over time, the brain begins to anticipate danger or symptoms, creating a loop where the fear of symptoms can actually sustain them.
This isn’t psychological, it’s neurobiological. But because the nervous system is changeable (plastic), this also means there’s hope for rewiring.
How Can This Knowledge Support Healing?
Understanding that symptoms are driven by a sensitized (but retrainable) nervous system is a game-changer. It shifts the focus from “What’s broken?” to “What needs calming, re-patterning, or support?”
Healing may involve:
Nervous system regulation (somatic practices, vagus nerve work)
Brain retraining (VIBE technique and neuroplasticity tools)
Addressing trauma and protective parts (IFS, EMDR, self-compassion)
Graded, gentle movement and pacing to rebuild safety
Lifestyle factors like sleep, nutrition, sun, connection, and meaning
Most importantly, it involves building a life and environment that signals safety to the nervous system, consistently and compassionately.
You’re Not Broken. You’re Adaptable
Nociplastic pain isn’t a dead end. It’s a sign that your nervous system is trying (too hard) to protect you. With the right tools and support, it can learn that it’s safe to shift from defence to rest, from overload to balance, from survival to healing.
If this concept resonates, know that you’re not alone. There’s a growing field of science, therapy, and community rooted in hope and grounded in neurobiology. Book a session with me today to talk more about how I can help!
