Central Sensitization

Central sensitization is a state in which the central nervous system amplifies pain processing: stimuli that would not normally be painful come to be perceived as pain, and pain persists beyond the expected healing time. It is a frequent component of chronic pain conditions in any part of the body.

Why the subtle approach is indicated

In an already sensitized system, intense stimuli tend to provoke exaggerated reactions. The logic of SMT Halili is the opposite: light touch and sustained positioning promote the release of tension gradually, activating the parasympathetic system and avoiding amplification of the pain signal (Bordoni & Zanier, 2015; Schleip & Müller, 2022).

To see this process in motion: the animation Central Sensitization, in plain language, and, for the model, Temporal Model of Central Sensitization.

The Temporal Model (TMCS)

Theoretical hypothesis

The Temporal Model of Central Sensitization (TMCS) is the theoretical foundation that guides protocol selection in SMT. It proposes a sequence of stages the nervous system goes through as it develops and maintains sensitization, suggesting which therapeutic targets may be most relevant at each phase.

It is important to be clear about the scientific status of the TMCS: it is a mechanistic hypothesis, presented and tested in the method's articles, not an established fact. SMT's clinical studies (see Evidence) test predictions derived from this model in retrospective cohorts, which provides observational support accumulated since 2015, though distinct from what a randomized trial would demonstrate.

Where this shows up in practice

The studies by region, which include the drainage and decongestion protocols with a cardiovascular emphasis, suggest that the method may contribute to modulating physiological mechanisms related to central sensitization and chronic pain. Favorable results were observed in the knee, lumbar spine, shoulder, hip, and trigeminal nerve territory; there are also clinical reports in conditions such as anxiety and irritable bowel syndrome, with no published study to date. The fact that a single therapeutic model shows possible benefits in such distinct clinical manifestations supports the hypothesis of a systemic action. However, this interpretation still needs further clinical studies.

→ See the data: Evidence by region