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Central Sensitization: Viewpoints in JOSPT


This article is recently published in JOSPT – (here)


Central sensitization is a physiological mechanism associated with enhanced sensitivity and pain responses. At present, central sensitization cannot be determined directly in humans, but certain signs and symptoms may be suggestive of it. Although central sensitization has received increasing attention in the clinical literature, there is a risk that certain distinctions are being lost. This paper summarizes current knowledge of the physiology of central sensitization and its possible manifestations in patients, in order to inform a debate about the relevance of central sensitization for physical therapists. It poses 6 challenges associated with the application of central sensitization concepts in clinical practice and makes suggestions for assessment, treatment, and use of terminology. Physical therapists are asked to be mindful of central sensitization and consider potential top-down as well as bottom-up drivers, in the context of a person-centered bio- psychosocial approach.

Key Points

  • Central sensitization is a physiological and reversible mechanism associated with enhanced sensitivity and pain responses.
  • Until better markers are available, detection of central sensitization in humans remains tentative.
  • We must be careful that the concept of central sensitization is not used interchangeably with psychological manifestations.
  • Let us keep an open mind about central sensitization as our knowledge about this in

About the author

Matt Low

Matt is a Consultant Physiotherapist in the NHS and is a visiting associate at the Orthopaedic Research Institute at Bournemouth University. He qualified from the University of Southampton and is a member of the Musculoskeletal Association of Chartered Physiotherapists (MACP) following completion of his Masters degree in Neuromusculoskeletal Physiotherapy at the University of Brighton.

Matt has lectured and examined for pre-registration and post-registration students at a number of Universities in the South of England. He has lectured on subjects such as motor control, spinal manipulation and clinical reasoning skills. He has interests in compassionate person-centred care, the theory of causation within the healthcare setting, philosophy, reflective practice and critical thinking skills.


Matt will join us in the future for a f2f course. This particular article is a great pre-read for Melissa Farmer’ talk in Le Pub Home Brew

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