Centralized pain syndrome is a disorder of the central nervous system (CNS). It develops due to changes in how the brain and spinal cord interpret pain signals, resulting in much higher sensitivity.

The brain is constantly receiving and interpreting messages from the body. In central pain syndrome, the pain receptors of the CNS become highly active, sending pain messages in response to stimuli that would not cause pain in a person without the syndrome. The brain also interprets pain in an exaggerated way.

Some people with the syndrome feel pain throughout the body, while others only feel it in a few specific areas. It is often constant, but can also come and go. Living with chronic pain can affect mood, energy, and quality of life.

Read on to learn more about central pain syndrome, including its causes, symptoms, and treatment. This article will also explain the differences between it and fibromyalgia, another painful condition.

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Central pain syndrome is a condition that affects the CNS. It occurs when sensory receptors in the brain and spinal cord do not sense pain in a typical way.

Usually, a pain signal lets a person know that something is not right. For example, a person will receive pain signals if they touch something hot, letting them know it is harmful. The nerves in the skin send these signals to the brain, which interprets the pain.

However, in central pain syndrome, the CNS is far more sensitive than usual. This makes it react to stimuli that are not harmful and do not typically cause physical pain, such as gentle touch, or no stimuli at all. The brain also interprets pain as being stronger.

This does not mean that the pain is not real or a product of a mental health condition. In central pain syndrome, the CNS is sending real pain signals. The key difference is that these signals are occurring for unknown or unusual reasons.

The primary symptom of central pain syndrome is pain with no known cause that lasts 3 months or more. Although the pain is usually constant, it can also be intermittent.

Something that does not typically cause physical pain may trigger symptoms. However, there is often no obvious trigger.

People may experience:

The symptoms can range from mild to severe.

Ideas about what causes central pain syndrome have changed over the years. In the past, doctors believed it could only occur after damage to the spinal cord or brain stem. However, there are other causes too.

Anything that causes dysfunction in how the CNS sends and receives pain messages may lead to central pain syndrome. This includes:

However, it also includes other risk factors, such as:

  • genetics
  • having other conditions that cause chronic pain
  • experiencing prolonged stress
  • psychological trauma
  • depression
  • obesity

Scientists believe a person’s risk of developing central pain syndrome is 50% genetic and 50% environmental. Emotional stress, early childhood trauma, and infection contribute to about 5–10% of cases.

Fibromyalgia is a chronic condition that has similarities to central pain syndrome. People with fibromyalgia also experience widespread, ongoing pain.

There is also an overlap in possible causes. Researchers are less sure about what causes fibromyalgia. However, it may also involve the nervous system. Additionally, it may share certain risk factors with central pain syndrome, including genetics, emotional distress, and trauma.

However, while central pain syndrome can occur due to direct damage to the brain, spinal cord, or nerves that is visible on a scan, fibromyalgia does not have this feature.

Fibromyalgia also has some different symptoms to central pain syndrome, including:

It is possible to have both fibromyalgia and central pain syndrome at the same time. The chronic pain of fibromyalgia may increase the risk of developing a highly sensitive CNS.

There is no specific test for central pain syndrome, and it has similarities to other conditions. This can mean a diagnosis takes time, as doctors will need to rule out other explanations.

A doctor will first gather a person’s medical history. This will include questions about:

  • any prior injuries, surgeries, or other medical conditions
  • when the pain started
  • where the pain is in the body
  • what it feels like
  • anything that makes the pain better or worse
  • other symptoms, such as mood or energy level changes, weakness, or stiffness

The doctor may then request tests, such as blood tests, medical imaging, or others.

Treatment for central pain syndrome can be multifaceted. This means it may involve a variety of strategies, and different people may find different things helpful.

Lifestyle and mental health approaches

Some nondrug treatments for central pain syndrome include:

These aim to improve quality of life and boost coping skills.


For pain that affects one area of the body, a doctor may suggest local injections of pain medication, also known as nerve blocks.

However, pain medications such as ibuprofen and opioids typically do not help with central pain syndrome.

Some other types of drugs appear to offer potential relief, such as:

  • Amitriptyline: This is a type of antidepressant. It may help reduce pain in some people, particularly when it originates in the brain.
  • Lamotrigine: This antiseizure drug may also have benefits for central pain syndrome.
  • Mexiletine: This is a drug that doctors typically use to treat an irregular heartbeat. In some cases, it may help with central pain syndrome that does not respond to other treatments.

The Food and Drug Administration (FDA) has approved other medications for central pain syndrome, such as gabapentin and pregabalin. However, studies on these drugs have mixed results.

All of these drugs can cause side effects. Some can cause dependence or lead to withdrawal symptoms if a person stops taking them. It is important to discuss this with a doctor to weigh up their potential risks and benefits.

Treatments under research

There is ongoing research into other ways to manage central pain syndrome, such as:

More studies are necessary to prove these are safe and effective.

Central pain syndrome is a neurological condition that involves changes in how the central nervous system registers pain. People with central pain syndrome feel pain in response to stimuli that would not cause pain in other people.

It can be difficult to diagnose central pain syndrome, and there are no surefire ways of treating it. Some people find relief with certain medications. A doctor may need to try a combination of strategies to reduce a person’s pain.