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Chronic pain and central sensitisation

Published 13 March 2026 ·Last reviewed 13 March 2026 by the editorial team ·How we create our content

A composite account, drawn from many real anonymised experiences. It is not any one person's story.

Chronic pain and central sensitisation

What this experience covers

This experience explores what happens when pain persists after the original colorectal condition has apparently healed — a phenomenon that can involve central sensitisation, where the nervous system continues to produce pain signals even though the tissue has recovered. It is a composite drawn from many anonymised accounts.

The pattern

When pain outlasts the condition

People describe a confusing and distressing experience:

  • The fissure has healed, the surgery was successful, the examination is normal
  • But the pain continues — sometimes identical to the original pain
  • Clinicians confirm there is no visible cause for the ongoing pain
  • The person is left wondering: if the problem is fixed, why does it still hurt?

What central sensitisation means

In plain terms: the nervous system has become “turned up.” After months of chronic pain, the nerves and brain have adapted to expect pain. They continue to send pain signals even when the original trigger has resolved. It is like an alarm system that has been triggered so many times it now goes off without a real threat.

This is not “in your head.” It is a recognised neurological phenomenon. The pain is real — the mechanism has simply shifted from tissue damage to nervous system sensitisation.

What it feels like

People describe:

  • Pain that feels identical to the original condition
  • Increased sensitivity — things that should not hurt now cause pain
  • Pain triggered by normal activities like sitting, walking, or bowel movements
  • Heightened anxiety which amplifies the pain perception
  • A sense that no one believes them because examinations show nothing

What helps

People describe improvement through:

  • Understanding the mechanism — knowing that sensitisation is real and treatable reduces the fear component
  • Pelvic floor physiotherapy — addressing the muscle tension that persists alongside the sensitisation
  • Graded exposure — gradually reintroducing activities that have become associated with pain
  • Psychological support — CBT for chronic pain is specifically designed for this pattern
  • Medication — nerve pain medications prescribed by a clinician
  • Time and patience — the nervous system can recalibrate, but it takes time

What people wish they had known

  • That pain can persist after healing and that this is a recognised phenomenon
  • That central sensitisation does not mean the pain is imagined
  • That there are specific approaches designed for this type of pain
  • That improvement is possible but requires a different approach than treating the original condition

Everyone’s situation is different. If you want to talk through yours in a private, judgement-free space, our chat is here.

When to contact your doctor

Seek medical attention if you experience:

  • Persistent pain after a condition has been confirmed as healed
  • Pain that is worsening or changing in character
  • New symptoms alongside the pain
  • The pain significantly affecting your quality of life
When to seek care Heavy bleeding or feeling faint? Get emergency help now. Emergency: 911

Not sure how urgent it is? Get help today.

  1. Emergency

    Heavy bleeding, black tarry stools, feeling faint, severe pain or trouble breathing.

    Call 911 or go to the ER.

  2. Today

    Fever, pain getting worse, a hot swollen lump, or trouble passing urine.

    Call your doctor or go to urgent care.

  3. Soon

    Bleeding or bowel changes nobody has checked, or anything lasting 3 weeks.

    Book a doctor’s appointment.

Feeling overwhelmed? Call or text 988, any time.

See all the signs

For this topic, get medical advice if you notice:

  • Severe or worsening pain
  • Heavy bleeding
  • Fever
  • Black stools
  • Fainting or dizziness
  • Pus or unusual discharge
  • Inability to pass stool or gas
  • Unexplained weight loss

Recording how you feel is not the same as being checked. These are the signs that need a doctor’s attention.

Call 911 or go to the emergency room now if you have:

  • bleeding that will not stop, a lot of blood (the toilet water turns red, or you pass large clots), or any bleeding with feeling faint or dizzy
  • fainting, a racing heart or trouble breathing
  • confusion or slurred speech, extreme shivering, no urine in a day, or blotchy skin
  • sudden severe belly pain, or a swollen, hard belly with vomiting or not passing stool or gas
  • you cannot pass urine at all, or your bladder feels full and painful and you can’t empty it
  • redness, swelling or severe pain spreading quickly around your anus, genitals or groin, especially with a fever or feeling very ill
  • a fever with a painful swelling near your anus if you have diabetes or a weakened immune system (for example, from chemotherapy or transplant medicines)
  • black, tarry stools

Call your doctor or go to urgent care today (or the ER if you can’t be seen today) if you have:

  • a temperature of 100.4°F (38°C) or higher, chills, vomiting, or feeling generally unwell
  • pain that is getting worse over days, or severe pain that stops you sitting or sleeping
  • a hot, swollen or very tender lump near your anus or at the top of the crease between your buttocks, or foul-smelling discharge
  • trouble urinating
  • bleeding that is getting heavier or more frequent, or blood mixed into your stool
  • feeling much more tired than usual, looking pale, or getting out of breath more easily than you used to
  • not passing stool for several days, or new belly pain

Make an appointment with your doctor if:

  • you have never had these symptoms checked by a doctor or nurse — whatever your age
  • you have had rectal bleeding for more than 3 weeks
  • your bowel movements have been looser, thinner or more frequent than usual for 3 weeks or more, or you have lost weight without trying
  • symptoms have not settled after a week or so, or keep coming back
  • you notice a new lump near your anus, between your buttocks or in your belly, or an itch or discharge that does not clear
  • you have new leakage or trouble controlling your bowels
  • you are 45 or over, or have a family history of bowel cancer or inflammatory bowel disease, and any of these symptoms are new for you

If you are unsure, it is always reasonable to ask. If things feel overwhelming, call or text 988 (Suicide & Crisis Lifeline) or chat at 988lifeline.org, any time. If you don’t feel safe, call 911.

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Discreet symptom tracking

Symptoms that come and go? Keep track, day by day.

For hemorrhoids, fissures, fistulas and other anal and rectal problems. A short, discreet email asks how things have been, and saves each answer, so you can look back at every flare and every good week in your own words. If you haven’t had your symptoms checked, see your doctor first.

  • About ten seconds a check-in. No app, no password.
  • Nothing in the subject or preview says what it’s about.
  • Each Sunday, a link to your week, ready for your next appointment.
Start tracking →

Your notes

Your check-in

Takes about ten seconds.

20:00
Example. Nothing on the lock screen hints at symptoms or conditions.

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