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Central sensitization
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=== Conditioned pain modulation: pain inhibits pain === Central sensitization doesnβt necessarily involve an increased susceptibility to stimuli; it can also be caused by a defect in the inhibitory pain pathways of the body. One highly researched mechanism in this respect is called 'conditioned pain modulation'<ref>{{Cite journal | last = Kennedy | first = Donna L. | authorlink = Donna Kennedy | last2 = Kemp | first2 = Harriet I. | last3 = Ridout | first3 = Deborah | last4 = Yarnitsky | first4 = David | last5 = Rice | first5 = Andrew S.C. | date = Nov 2016 | title = Reliability of conditioned pain modulation | url =http://dx.doi.org/10.1097/j.pain.0000000000000689 | journal = PAIN | volume = 157 | issue = 11 | pages = 2410β2419|doi=10.1097/j.pain.0000000000000689|issn=0304-3959}}</ref> (CPM; an older name is 'diffuse noxious inhibitory control'). This refers to the fact that pain in one area of the body can decrease pain in another area. The chronic pain in your back for example might lessen if you sprain your ankle because your brain will focus more on the new information and dampen the other pain stimuli it receives. Meeus & Nijs of the Pain in Motion group tested this using heat stimuli and reported that conditioned pain modulation was normal but delayed in ME/CFS patients.<ref name=":6" /> In four other studies, <ref name=":7" /><ref name="MeeusIck2013">{{Cite journal | last = Meeus | first = Mira | last2 = Ickmans | first2 = Kelly | last3 = Struyf | first3 = Filip | last4 = Hermans | first4 = Linda | last5 = Van Noesel | first5 = Kevin | last6 = Oderkerk | first6 = Jorinde | author-link6 = Jorinde Oderkerk | last7 = Declerck | first7 = Luc S. | last8 = Moorkens | first8 = Greta | last9 = Hans | first9 = Guy | date = Mar 2013 | title = Does acetaminophen activate endogenous pain inhibition in chronic fatigue syndrome/fibromyalgia and rheumatoid arthritis? A double-blind randomized controlled cross-over trial | url = https://www.ncbi.nlm.nih.gov/pubmed/23511692 | journal = Pain Physician | volume = 16 | issue = 2| pages = E61β70|issn=2150-1149|pmid=23511692|quote= | authorlink = Mira Meeus | author-link2 = Kelly Ickmans | author-link3 = Filip Struyf | author-link4 = Linda Hermans | author-link5 = Kevin Van Noesel|via=}}</ref><ref name=":12" /><ref name=":15">{{Cite journal | last = Ickmans | first = Kelly | last2 = Meeus | first2 = Mira | last3 = De Kooning | first3 = Margot | last4 = Lambrecht | first4 = Luc | last5 = Pattyn | first5 = Nathalie | last6 = Nijs | first6 = Jo | date = Sep 2015 | title = Associations Between Cognitive Performance and Pain in Chronic Fatigue Syndrome: Comorbidity with Fibromyalgia Does Matter |url =http://dx.doi.org/10.1016/j.physio.2015.03.3465 | journal = Pain Physician | volume = 18 | issue = 5| pages = E841β852|issn=2150-1149|pmid=26431138|quote= | authorlink = Kelly Ickmans | author-link2 = Mira Meeus | author-link3 = Margot De Kooning | author-link4 = Luc Lambrecht | author-link5 = Nathalie Pattyn|via= | author-link6 = Jo Nijs}}</ref> the same research group tested CPM using the pressure of an inflatable occlusion cuff as the conditioning stimulus. In all cases there were no significant differences between ME/CFS patients and healthy controls.
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