Understanding Pain Sensitisation: Why Long-Term Pain Behaves Differently

kerryread14
Dec 1
2 min read

Long-term pain doesn’t play by the same rules as new or short-lived pain. Many people feel confused when their pain lasts longer than expected or flares up without any obvious cause. This can lead to frustration, fear, and reduced activity, all of which can make things feel worse.

The good news is this:long-term pain is changeable, manageable, and treatable once you understand what’s driving it.

This is where the concept of pain sensitisation becomes essential.

What Is Pain Sensitisation?

Pain sensitisation happens when the nervous system becomes more responsive to signals from the body. Over time, the body may produce pain even when the tissues are not being damaged.

It’s a bit like the alarm system becoming overly sensitive. Going off at the slightest movement, stress, or change in temperature.

This can show up as:

Pain that lingers long after an injury has healed
Pain that spreads beyond the original area
Pain from normally non-painful activities (light touch, gentle exercise)
Unpredictable flare-ups
More intense pain than expected for the activity

This doesn’t mean the pain is “in your head.” It means your nervous system is working too hard to protect you.

Why Does Sensitisation Happen?

Sensitisation can develop for many reasons:

A previous injury or surgery
Repeated flare-ups over months or years
Stress, anxiety, and poor sleep
Reduced activity levels
Long-term inflammation or illness
Fear of movement
Chronic muscle tension and guarding

Your body adapts to what it experiences often. If it has experienced pain repeatedly, the nervous system becomes very efficient at producing it.

Why Long-Term Pain Behaves Differently

Unlike acute pain, long-term pain:

Isn’t always linked to damaged tissues
May not respond to rest alone
Can flare up with stress or fatigue
Can improve even if the original injury can’t be “fixed”
Responds strongly to movement, pacing, and lifestyle habits

Understanding this difference removes fear and encourages a more confident return to movement.

Key Strategies to Calm a Sensitised Nervous System

1. Gentle, Consistent Movement

Movement reassures the nervous system.Start small: walking, stretching, or light home exercises.

2. Pacing Activities

Break tasks into smaller chunks to avoid flare-ups and to build tolerance over time.

3. Strengthening

Building strength helps your body feel safer and more supported, reducing over-protection.

4. Relaxation and Breath work

Deep breathing, mindfulness, and relaxation help calm the nervous system and reduce tension.

5. Quality Sleep

Poor sleep amplifies pain signals. Even small improvements matter.

6. Education

Understanding pain reduces fear, and fear is one of the biggest drivers of long-term pain.

How Physiotherapy Helps

A physiotherapist trained in pain science can help you:

Understand your pain
Reduce flare-ups
Improve strength and confidence
Find movements that work for your body
Build a personalised pacing plan
Move safely without fear

Long-term pain is real. But it is also changeable. With the right strategies, you can regain control.