When you or your child lives with a condition like Hemicrania Continua (HC)—a relentless, one-sided headache that never entirely goes away—you quickly learn that pain is never just physical. It touches your routines, your sleep, your family, and your mental health. Sometimes, even when a treatment is helping, the pain lingers in weird, unpredictable ways. You might think: Why is this still hurting?

This could be the result of a phenomenon called central sensitization, a neurological condition that causes the brain and spinal cord to become more sensitive to pain. It’s real, it’s well-researched, and it’s something many people with chronic pain—especially invisible conditions like HC—struggle with.

Central Sensitization, Explained

Central sensitization happens when the central nervous system (your brain and spinal cord) becomes overly responsive to pain signals—or even starts creating them on its own. Over time, the body reacts to pain as if it’s a constant threat, even when there’s no fresh injury or trigger.

How it works:

• Your nerves send pain messages to your spinal cord and brain.

• In chronic pain conditions, the brain becomes hyper-alert to these signals.

• It starts interpreting non-painful input (like light touch or temperature) as painful.

• Pain becomes more widespread, lasts longer, and feels more intense than it “should.”

It’s like your pain dial is stuck on high—and no one gave you the remote.

Why It Matters in Hemicrania Continua (and Other Chronic Conditions)

Hemicrania Continua is a type of Trigeminal Autonomic Cephalalgia (TAC) that causes continuous, one-sided head pain, often accompanied by eye redness, tearing, and nasal symptoms. It’s uniquely responsive to indomethacin, but even then, many people still experience persistent pain.

That’s where central sensitization may come into play. When the brain has been dealing with pain 24/7—especially if it’s been misdiagnosed or untreated for years—it can shift into this hyper-sensitive state. That means even mild stimuli can feel overwhelming, and treating the original cause of pain doesn’t always fix the experience of pain.

Signs central sensitization might be involved:

• Pain that lingers

• Increased sensitivity to light, noise, or touch

• Feeling exhausted by pain in multiple parts of the body

• Anxiety or fear of triggering pain

• Migraine treatments help… but not completely

Conditions Often Linked With Central Sensitization

While central sensitization isn’t a diagnosis in itself, it’s a shared mechanism across many chronic conditions—especially those involving invisible or complex pain. If you or your child has one or more of these, central sensitization could be part of the picture:

• Hemicrania Continua

• Fibromyalgia

• Chronic migraine

• Temporomandibular joint disorder (TMJ)

• Irritable bowel syndrome (IBS)

• Complex Regional Pain Syndrome (CRPS)

• Endometriosis

• Post-viral pain or Long COVID

What Helps Central Sensitization?

There’s no single “cure” for central sensitization, but there are strategies that can help calm the nervous system over time. These are most effective when used together and tailored to the individual’s needs and tolerance.

Helpful treatments and tools may include:

• Gentle physical therapy or movement to retrain pain responses

• Cognitive behavioral therapy (CBT) to address the fear-pain loop

• Medications like SNRIs (e.g., duloxetine) or low-dose naltrexone (LDN)

• Biofeedback or neurofeedback

• Mindfulness and paced breathing

• Sleep support—because poor sleep worsens sensitization

• Nutrition that reduces inflammation and supports nerve function

Some patients with HC have found that once their pain is reduced by indomethacin, nervous system-focused care helps prevent their brain from staying stuck in high-alert mode.

A Word to Parents (and Patients Who Feel Like They’ve Tried Everything)

If you’re caring for a child with HC or another chronic condition, central sensitization can feel like an invisible thief. You’re doing all the “right” things—giving meds, advocating for care—and the pain still seems to live in their skin.

It doesn’t mean you’re failing them. It means their nervous system needs time, gentleness, and consistency to unlearn a pattern that took months or years to build.

And if you are the patient reading this, feeling like your body is stuck in pain mode even when treatments “should” be working—please hear this: your pain is real, and we see you.

Summary

Central sensitization is when the brain and spinal cord get stuck in an overprotective pain loop. It magnifies even small pains, turning touch into discomfort, and often lingers after the original cause of the pain is addressed.

For people with Hemicrania Continua, especially children or those who’ve gone undiagnosed for years, central sensitization can complicate treatment—but it’s not a dead end. With the right tools and compassionate care, the nervous system can calm down.

Healing might not look like flipping a switch. It might look like unlearning pain, moment by moment, and giving your brain permission to rest.