Central Sensitization and the Role of Stress

Central sensitization happens when the nervous system becomes overly reactive. Even normal sensations like walking, stretching, or emotional stress can trigger pain. This can result from years of physical or emotional stress, past injuries, or trauma.

When the brain is exposed to long-term stress or feels stuck in protection mode, it can start to view harmless signals as threats. This leads to a nervous system that is always on high alert and quick to send pain signals, even when nothing is wrong in the body.

PRT helps calm this overactive response, guiding the brain to interpret sensations more accurately and to feel safe again.

JOURNAL PROMPT

How might life-time stressors contributed to your pain today?

How Stress and Fear can create a conditioned response

A conditioned response is a learned reaction that develops when our brain repeatedly associates a certain trigger with a perceived threat or danger. Over time, this response becomes automatic, even if the original threat is no longer present.

In the case of chronic pain, the brain can begin to interpret safe situations, movements, or environments as dangerous because of past experiences. For example, if bending over once caused a sharp pain, the brain may start sounding the alarm every time you bend, even after the injury has healed. This happens because the nervous system has learned to expect danger in that context, creating a conditioned response of pain, tension, or fear.

Our environment also plays a big role. If certain places, people, or even times of day became associated with pain or stress, the brain may stay on high alert in those settings. This constant scanning for danger keeps the nervous system activated, which can amplify pain signals and reinforce the belief that something is still wrong.

The good news is that these conditioned responses are not permanent. Through awareness, gentle exposure, and techniques like pain reprocessing, we can teach the brain new associations.

examples of Conditions Responses

Environment Triggers

Example:
A person frequently experienced migraines at work due to stress. Now, just walking into the office triggers a headache—even on a calm day.

Conditioned Response:
The brain has associated that environment with danger and stress, and now activates pain as a protective signal in that space.

Posture or Position

Example:
After neck pain from poor posture at a desk, someone starts feeling discomfort every time they sit in a chair, even with good posture and support.

Conditioned Response:
The brain has associated sitting with harm, so it maintains a pain response to prevent what it thinks is re-injury.

Time of Day

Example:
Someone always felt joint pain in the evening when their body was most tired. Eventually, the pain starts like clockwork every night—even when they are rested.

Conditioned Response:
The brain has learned to expect pain at that time, so it produces symptoms based on the expectation, not actual need.

Sound or Smell

Example:
A person had a panic attack in a crowded room with loud music. Now, whenever they hear similar music, they feel anxious or even develop chest tightness.

Conditioned Response:
The nervous system links that sound with a past threat and triggers a protective (but unnecessary) response.