I got a good question in e-mail as to how this chronic pain research helps treatmentwise. I've been reading about this, plus the pain clinic I go to knows a lot about this. The good thing about these central nervous system changes is that in some cases they can be at least partially reversed. I had pretty severe hypersensitivity bordering on reflex sympathetic dystrophy and it's gotten a lot better (although not completely normal). The pain clinic approach involves several things:
a) It's really important to get your pain under control to not reinforce this problem. So they're really aggressive about pain meds (and blocks if needed) and also making sure you don't do exercises in PT that aggravate your symptoms.
b) Conversely pain free movement is really important in reeducating your nervous system. According to the pain clinic, this will actually make changes in your brain. Most good pain clinics include a program of graded aerobic exercise. I found it difficult to figure out how to move towards being aerobic and correcting muscle imbalances/weaknesses without increasing pain but their physical therapist really helped me figure this out.
c) For some people, cognitive behavioral therapy really helps. It's interesting that they have shown through functional MRIs that this kind of therapy can actually induced changes in the brain.
There are also some interesting research where they look at physiologic changes trained yogis have to pain, so it seems like some of this mind/body stuff has a real physical basis, which I suppose is not surprising to anyone that practices it.
The paper below makes the point that many of the symptoms that are traditionally labeled nonorganic, psychosomatic (including the well known Waddells signs that are supposed to show you don't have a real back problem) are likely signs of this central nervous system changes due to chronic pain. Some people can have these changes persist after the original injury has healed.
It's interesting that some pain clinics and infamous Dr. Sarno method often include a) b) and c) for supposedly psychosomatic back problems and get good results. It makes me wonder how many of those people have this central hypersensitivity as the underlying problem. I was always baffled as to how Sarno could get good results in some patients given what totally unscientific his �research� is. Conversely, it would seem his treatment failures are not people �who don't believe the theory� as he claims but people for whom this central hypersensitivity is not the main problem.
In my case, the underlying organic problem is still present, however this central hypersensitivity was amplifying the pain, so their treatment was helpful in reducing my pain even though it didn't remove it.
A book written for patients about this research and how to use it in your treatment by some of the people who trained people at my pain clinic is described in the following link if you are interested.
www.noigroup.com/ep/index.html