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Dr. Gary Kaplan Explains Central Sensitization Syndrome in The Pain Practitioner

Dr. Gary Kaplan, along with co-author Juliana Heimur, BA, recently contributed to The Pain Practitioner, the quarterly magazine published by the American Academy of Pain Management (AAPM). The article, titled “Microglia and Central Sensitization Syndrome: A New Paradigm for Understanding and Treating Chronic Pain and Depression,” discusses the role of microglia, a type of glial cell present in the central nervous system, as the mediator in the inflammatory process found to be present in central sensitization.

Central Sensitization Syndrom (CSS) is an inflammatory condition that damages the structure and undermines the functioning of the nervous system. It is both “neurodysregulatory” and “neurodegenerative.” Neurodysregulation refers to the extent to which CSS interferes with the healthy functioning of the body’s nervous system, undermining neural activity in the brain, spinal cord and other neural pathways throughout the body. Furthermore, when a person’s nervous system is operating sub-optimally, their hormonal and immune systems are likely to falter, which in turn, can lead to even more complicated health problems. Neurodegeneration refers to the actual injury and destruction of neural tissue in the brain and body. Both conditions (neurodysregulation and neurodegeneration) can cause or exacerbate physical pain, emotional suffering, and erode mental clarity. The mediating factor in this process is the production and release of inflammatory substances in the brain.

At the cellular level, the fundamental mediator of CSS is the microglia. What we are learning about the pathophysiology of CSS enables us to formulate a new paradigm for understanding how a variety of seemingly unrelated illnesses and traumas can result in CSS. In this article Dr. Kaplan discusses the research on the neurobiology of microglia and their role in the occurrence of central sensitization with emphasis on the clinical implications and application of this research.

Please click here or on the image below to download and read Dr. Kaplan’s featured article.