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Editorial Review (Thematic Issue: An Update on Central Sensitivity Syndromes and the Issues of Nosology and Psychobiology)
Abstract
Central sensitization (CS), simply defined as an amplified response of the central nervous system to peripheral input, is a concept of great importance in clinical medicine. It has helped to explain aspects of the pathophysiology of common diseases, e.g. fibromyalgia syndrome (FMS), irritable bowel syndrome, vulvodynia, headaches, chronic pelvic pain and other overlapping conditions (collectively called central sensitivity syndromes, or CSS). It also applies to pain of complex regional pain syndrome, osteoarthritis (OA), rheumatoid arthritis (RA) and post-operative pain. The pathology-pain gap in CSS is readily explained by CS. Many FMS and other CSS patients have peripheral pathology, e.g. nociceptive areas in the muscles, arthritis, small fiber neuropathy and inflammation. Pro-inflammatory cytokines are elevated in some patients. Identification of CS in patients with structural pathology, e.g. OA and RA, has helped to explain why not all patients benefit from nonsteroidal anti-inflammatory drugs or joint replacement surgery, and require therapy directed at CS. Glial cells are important in pain processing. Remarkable advances have been achieved in neuroimaging, including visualization of grey matter and white matter, not only during provoked pain but also pain at rest. Based on CS mechanisms, targeted individual therapy may now be possible. Appropriate nosology is important particularly for effective patient care. Dichotomy of neurochemical-structural ("functional") and structural ("organic") pathology should be abandoned; many patients have both. Psychobiology is also biology. Patient-blaming terms like somatization, somatizer and catastrophizing should be avoided. For therapy, both pharmacological and non- pharmacological approaches are important, including recognition of subgroups and person/patient-centered care.
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“Against this background, the similarity in widespread hypersensitivity between IBS patients and CPCS, such as FMS, led to the view that IBS is another CCS [10,11].”
From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [11]
In the citing paper
“Although it is not clear how these physiologic alterations are generated, there is a wide agreement that FMS should be considered as a CPSS [9,10,11,32,33,34].”
From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [11]
In the citing paper
“According to the classification developed by M. B. Yunus on central sensitization syndromes (2007; 2009; 2015), those that involve the experience of chronic pain could be considered as CPSS [9,10,11].”
From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [11]
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Additional file 4 of Tests for central sensitization in general practice: a Delphi study
den Boer, C., Terluin, B., van der Wouden, J. C., Blankenstein, A. H., & van der Horst, H. E. (2021) · Figshare · doi:10.6084/m9.figshare.16835051
Additional file 1 of Tests for central sensitization in general practice: a Delphi study
den Boer, C., Terluin, B., van der Wouden, J. C., Blankenstein, A. H., & van der Horst, H. E. (2021) · Figshare · doi:10.6084/m9.figshare.16835042
Additional file 3 of Tests for central sensitization in general practice: a Delphi study
den Boer, C., Terluin, B., van der Wouden, J. C., Blankenstein, A. H., & van der Horst, H. E. (2021) · Figshare · doi:10.6084/m9.figshare.16835048
Additional file 6 of Tests for central sensitization in general practice: a Delphi study
den Boer, C., Terluin, B., van der Wouden, J. C., Blankenstein, A. H., & van der Horst, H. E. (2021) · Figshare · doi:10.6084/m9.figshare.16835057
Additional file 2 of Tests for central sensitization in general practice: a Delphi study
den Boer, C., Terluin, B., van der Wouden, J. C., Blankenstein, A. H., & van der Horst, H. E. (2021) · Figshare · doi:10.6084/m9.figshare.16835045
Additional file 5 of Tests for central sensitization in general practice: a Delphi study
den Boer, C., Terluin, B., van der Wouden, J. C., Blankenstein, A. H., & van der Horst, H. E. (2021) · Figshare · doi:10.6084/m9.figshare.16835054
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“The concept of neuronal sensitization, first proposed by Kandel [52] in 1976 and later expanded by Woolf [53], Yunus [32,54], Staud [55], and Nijs [56], serves as a unifying neurophysiological mechanism underlying CSS.”
Nacar, N. E., Tüfekçi, O., Ekici, M., et al. (2026) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2026.03.019
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Metadata
- Authors
- Yunus, M.
- Corresponding author
- Yunus, Muhammad
- Venue
- Current Rheumatology Reviews
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2015-07-02
- Volume
- 11
- Issue
- 2
- Pages
- 70-85
- ISSN
- 1573-3971 (ISSN-L)
- OpenAlex
- W843849817
- Cited by
- 226
- References
- 0
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 12 · 2023: 15 · 2022: 29 · 2021: 33 · 2020: 19 · 2019: 21 · 2018: 24 · 2017: 31 · 2016: 19 · 2015: 2
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Rheumatology Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- central sensitization, central sensitivity syndromes, fibromyalgia, irritable bowel syndrome, vulvodynia, chronic pelvic pain, complex regional pain syndrome, osteoarthritis, rheumatoid arthritis, postoperative pain, inflammatory cytokines, glial cells, neuroimaging, disease classification, psychobiology, somatization, catastrophizing, person-centred care, pain pathophysiology
- MeSH terms
- Animals, Disease Models, Animal, Humans, Central Nervous System Sensitization, Chronic Pain, Pain Management, Neuroimaging
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