Both Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FMS) are difficult to diagnose. These illnesses have a wide range of symptoms that affect multiple systems in the body. They are also linked to various psychological symptoms. In some cases, these conditions are accompanied by a host of other illnesses and most of these are difficult to diagnose.
While scientists and medical researchers are still working hard to study these conditions, there is an umbrella term being used to call them. This term is known as the Central Sensitivity Syndromes or CSS. Some researchers believe that this is the right term to call these conditions and it should replace the other terms such as functional somatic syndrome, medically unexplained syndrome, and somatoform disorders.
So what exactly is central sensitivity syndrome?
What Is a Central Sensitivity Syndrome?
Central Sensitivity Syndrome (CSS) refers to conditions that have to do with the central sensitization. The “central” here refers to our central nervous system and it consists of your brain and the spinal cord. Meanwhile, “sensitization” refers to the end result of your sensitivity to certain things.
When it comes to sensitivities, most people would think of allergies. Usually, if you are allergic to something, your body will react physically, even though some other people do not have any of these reactions at all. As a matter of fact, even though the sensitivities of CSS are not necessarily due to allergies, they still involve inappropriate physical reactions.
If you have CSS, you will be sensitive to things that are being processed through the central nervous system and this can include loud noises, bright lights, and certain chemicals or food. This is especially the case for those with fibromyalgia where the body tends to react to anything that is unpleasant, such as heat, cold, itch, tickle, etc.
Central Sensitivity Syndrome Conditions
Aside from fibromyalgia and CFS, the following conditions are also considered CSS. Some of these may co-exist with fibromyalgia or CFS:
- Irritable bowel syndrome
- Interstitial cystitis or pain in the bladder
- Idiopathic low back pain
- Chronic pelvic pain
- Temporomandibular joint disorder (TMJ)
- Restless legs syndrome
- Primary dysmenorrhea or painful period cramps
- Myofascial pain syndrome
- Multiple chemical sensitivity
- Migraine and headache
Psychiatric disorders are also common for those who have CSS. Research shows that the reason is that these disorders are linked to the dysregulation of similar neurotransmitters, to the dysregulation in CSS on the various regions of the brain and that of the psychiatric disorders.
The following psychiatric conditions that are known to overlap with the CSS are the following:
- Post-traumatic stress disorder
- Panic attack
- Obsessive-compulsive disorder (OCD)
- Major depression
- Generalized anxiety disorder
- Bipolar disorder
Features of CSS
Abnormal levels or activities of neurotransmitters are often responsible for CSS pain and symptoms. The neurotransmitters that are involved in some of the CSS include the following:
- GABA and glutamate
The pain that a patient would feel in CSS is a result of a couple of abnormal pain types known as hyperalgesia and allodynia.
Hyperalgesia will follow same feeling of pain from things that all people will find painful, such as when having a toothache or broken limb, but will make it even worse. This abnormal pain type is also being referred to as something that turns up the volume of pain. Because of hyperalgesia, injuries, surgeries and other origins of pain can become debilitating.
On the other hand, allodynia will make you feel pain even when these things should not hurt, such as the brushing of fabric against your skin. In fact, even if your arms are at rest while you are sleeping, you may still feel pain. Furthermore, allodynia will make your clothes feel painful even though they are not tight or pressing against your skin. In some patients, allodynia will make it difficult for them to get a hug because even a simple embrace can make them feel uncomfortable. Basically, it turns normal experiences into something painful, which is why patients have to make drastic changes in order to manage these conditions.
Other Proposed Mechanisms of CSS include the following:
- Dysfunction of the automatic nervous system
- Inflammation of the nervous system
- Dysfunction of the HPA axis, a component of the stress-response system of the body.
Treating Central Sensitivity Syndromes
The individual symptoms and mechanisms of CSS will require a personalized approach for treatment. However, in general, most CSS conditions are able to respond well to different kinds of treatment, including antidepressants. These medications can help to correct the dysregulation of the neurotransmitter. Other treatments may include exercising and cognitive-behavioral therapy (CBT).
But it is worth noting that people who have Chronic Fatigue Syndrome have special considerations when it comes to exercising and CBT is a very controversial treatment, especially when it’s combined with graded exercise.
Although these conditions are related to each other, it is important to have each of these conditions diagnosed in order to find the proper treatment. Talk to your doctor if you experience any symptoms that may not be related to your present diagnosis.
The classification of CFS and FMS as a central sensitivity syndrome is actually good news to those who have these conditions. It must be considered as a positive sign in terms of how these conditions are understood and viewed in the medical community. Instead of addressing the symptoms of the conditions, scientist can focus on the root source of the problem which is some form of abnormality in our central nervous system.
Hopefully, it will lead to more research attention which will eventually result in the more efficient diagnosis and treatment of these conditions.