Making Sense of Nervous System Dysfunction with the Central Sensitization Algorithm
From Confusion to Algorithm: Why This Matters
Complex or “medically unexplained” pain rarely exists in isolation. Patients often arrive with an alphabet soup of diagnoses—migraine, IBS, CRPS, POTS, MCAS, brain fog, severe insomnia. Traditional approaches often fail to explain this clustering, let alone offer holistic treatment.
The “Central Sensitization Algorithm” provides a way to make sense of these often overlapping and vague symptoms, and guide both assessment and management.
The Spectrum of Sensitization—Seven Major Buckets
Rather than chasing dozens of disconnected diseases, this framework groups symptoms into seven main domains:
Sensory Hypersensitivity: Pain out of proportion, allodynia, light/sound/touch/heat/cold sensitivities, fibromyalgia, TMJ disorder, vulvodynia.
Sleep Disturbances: Trouble falling or staying asleep, unrestful sleep, sleep apnea, parasomnias.
Fatigue: Chronic or excessive fatigue not explained by other causes, post-exertional malaise, narcolepsy.
Cognitive Dysfunction: Brain fog, memory issues, attention difficulties, post-concussion syndrome, ADHD-like symptoms.
Mood Disturbance: Anxiety, depression, PTSD, irritability, stress, anhedonia.
Motor Dysfunction: Tremors, jerks, non-epileptic seizures, movement disorders, motor control/inhibiition
Dysautonomia: Autonomic nervous system dysfunction presenting as things like POTS, GI symptoms (IBS), urinary issues, abnormal sweating, cardiopulm issues, sexual dysfunction etc
These symptoms often interact and amplify each other. The more domains affected, the more sensitized the nervous system—and the more complex recovery becomes.
Underlying Drivers—How To Use the Algorithm in Practice
● Step 1: Pattern Recognition
Group symptoms into the seven domains, look for clustering.
● Step 2: Seek Primary Drivers
Identify and treat drivers: neuroinflammation (long COVID, Gulf War Syndrome), autoimmune/inflammatory conditions, hormonal/metabolic disorders (thyroid, diabetes), longstanding stress or trauma, sleep pathology, hypermobility.
● Step 3: Reduce Amplifiers
Treat modifiable amplifiers wherever possible (address sleep apnea, treat depression/anxiety, improve nutrition/lifestyle and movement).
● Step 4: Collaborative Management
Set expectations—most cases require a team (doctor, coach, PT, psychologist), regular re-evaluation, and flexibility as symptoms evolve.
● Step 5: Maintain Empathy and Partnership
Remember, most patients have already experienced cycles of disbelief and blame. Emphasize “I believe you,” “We will keep looking,” and “Every symptom is real, even when hard to explain”.
Why the Algorithm Matters
The central lesson: chronic pain and associated symptoms often represent a network-level, neuroinflammatory process affecting multiple body systems and organs. While science advances, humility and structured frameworks are both essential—the goal isn’t to blame patients, but to recognize patterns, reduce suffering, and offer hope grounded in partnership and ongoing inquiry.
Our Takeaway For You:
In all three frameworks, the recurrent themes are:
● Respect for uncertainty.
● Patient validation.
● Honest, nuanced explanations that blend history, neuroscience, and real-life limitations.
● Practical plans grounded in empathy and shared responsibility.
The “algorithm” is not just medical—it’s a way to reclaim trust and dignity for patients lost in the maze of unexplained pain, and a way for clinicians to make sense of an otherwise confusing and overwhelming picture.