You may have noticed this in your practice. People with chronic pain, fibromyalgia syndromes (FMS), OA, RA or migraines also tend to have hypersensitivity to certain perfume smells, bright lights, loud noises, cold temperatures, or a simple touch to their skin.
This generalized hypersensitivity is referred to either as Multisensory sensitivity (MSS) or Central sensitivity syndromes (CSS)… whatever name you choose to call it, this condition seems to be strongly associated with central sensitization.
The nervous system of an individual with MSS/CSS basically amplifies even mildly threatening sensations, be it a foul smell or an annoying sound.
“CSS diagnoses and symptoms appear to be very common in the autistic population.” – Grant et al 2022
Interestingly, MSS/CSS has been shown to be more prevalent in people with ADHD and autism which is also associated with chronic pain… it’s complex!
“Autistic women were more likely to report a CSS diagnosis and experienced more CSS symptoms than men” – Grant et al 2022
So, the next time your patient admits to sensitivity to the cold or air-conditioning or that they are bothered by fluorescent lights or that they experience headaches if they smell perfumes on people… they likely have MSS/CSS.
Unfortunately, this also means that they may be hypersensitive to all pain inputs… even when it is mild.
This is a logical explanation of why 2 people may experience an identical physical injury, while one experiences minimal symptoms and the other experiences unrelenting pain requiring strong pain medications and months of futile physiotherapy.
If you are interested in clinically evaluation MSS/CSS on your patients, there is a Multisensory Amplification Scale (MSAS) that is available online.
Want to see if you have MSS/CSS?
How much do you agree with the following statements?
- I can’t stand smoke, smog, or pollutants in the air.
- Sudden loud noises really bother me.
- I hate to be too hot or too cold.
- I am quick to sense the hunger contractions in my stomach.
- Strong perfumes or colognes really bother me.
- I am often bothered by background sound like a dripping faucet or passing train.
- I can’t stand certain food textures (e.g., pudding, cottage, cheese or oysters).