Central sensitization and the biopsychosocial approach to understanding pain

Medical interventions alone have been largely unsuccessful in treating and curing disorders characterized by chronic pain like central sensitivity syndromes (CSS; e.g., fibromyalgia, chronic migraine, temporomandibular disorders, irritable bowel syndrome). In this article, we discuss how a biopsychosocial perspective adds to understanding people's experiences with chronic pain. A biopsychosocial perspective examines how biological, psychological, social, and contextual factors work independently and jointly to influence the experience, maintenance, and exacerbation of CSS and their symptoms. We highlight several key psychological and social factors relevant to many people who live with CSS, while also emphasizing the heterogeneity in people's experiences, life courses, and symptoms. Furthermore, we emphasize that the psychological, social, and contextual factors that we include are best characterized as contributors to chronic pain experience rather than causes of it.