Central sensitization and functioning in patients with chronic low back pain: A cross-sectional and longitudinal study

Echeita, Jone Ansuategui; Preuper, Henrica R. Schiphorst; Dekker, Rienk; Reneman, Michiel F.

doi:10.3233/bmr-210322

Cited by 6 publications

(5 citation statements)

References 53 publications

(61 reference statements)

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“…On the other hand, when a subgroup of patients with persistent MSK-D is examined, the presence of signs of CS seems to be present and of marginal importance in giving indications on the course of symptoms, as these will, in any case, only improve to a limited extent. 68,69 Probably, this reason justifies the slightest difference that emerges from this SR in signs of CS found between samples with two persistent MSK-D present at the same time and subjects with only one MSK-D. 44,51…”

Section: Central Sensitization In People With Msk-d and Chronic Comor...mentioning

confidence: 78%

Signs of Central Sensitization in Patients With Musculoskeletal Disorders and Chronic Comorbidities: A Systematic Review and Meta-Analyses of Observational Studies

Sgarbi

D'Alessandro

Castaldo

et al. 2023

Preprint

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Objectives: this review aimed to investigate the presence of signs of central sensitization in patients with musculoskeletal disorders and associated chronic comorbidities. Methods: we conducted a systematic review (prespecified protocol CRD42021228970). Two authors independently searched for primary studies published between 2000 and 2021 in Web of Science and PubMed databases. We searched for studies that investigate the presence of signs of central sensitization in patients with musculoskeletal disorder or migraine and a chronic comorbidity. Two authors independently evaluated the methodological quality of the included studies using the The Joanna Briggs Institute Critical Appraisal tools. When studies were judged homogenous enough, we performed a random effect metaanalysis. Results: we included 14 observational studies. Overall, patients with musculoskeletal disorders or migraine with an associated comorbidity showed more signs of central sensitization compared with healthy subjects. The quantitative analysis showed that patients with temporomandibular disorders and chronic comorbidities, compared to patients with temporomandibular disorders without comorbidites, have a decreased pressure pain thresholds measured in the masseter area [SMD: -0.52; CI 95%: -1.02 to -0.03; I2: 67%] and in the trapezius area [SMD: -0.55; CI 95%: -0.96 to -0.14; I2: 0%]. Patients with migraine, chronic low back pain or rheumatoid arthritis and associated fibromyalgia present more signs of central sensitization, measured in different modalities, than subjects without comorbidity. Conclusions: we demonstrated that, in general, patients with musculoskeletal disorders and an associated comorbidity showed an increased incidence of signs of central sensitization compared to healthy subjects and patients with musculoskeletal disorders without comorbities. Keywords: central nervous system sensitization, musculoskeletal diseases, temporomandibular disorders, osteoarthritis, fibromyalgia, comorbidity

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Section: Central Sensitization In People With Msk-d and Chronic Comor...mentioning

confidence: 78%

Signs of Central Sensitization in Patients With Musculoskeletal Disorders and Chronic Comorbidities: A Systematic Review and Meta-Analyses of Observational Studies

Sgarbi

D'Alessandro

Castaldo

et al. 2023

Preprint

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“…They all used very short HRV measurement protocols (10 min or less) and found little associations with central sensitization, catastrophizing, fear of movement, and disability. [21][22][23] A previous meta-analysis of HRV studies comparing chronic pain subjects with pain-free controls showed evident differences in HRV measures. 8 The results of this meta-analysis were heavily influenced by studies that included subjects with fibromyalgia, which was not the case in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Only three previous studies have directly assessed the association of PROMs to HRV in CMP subjects. They all used very short HRV measurement protocols (10 min or less) and found little associations with central sensitization, catastrophizing, fear of movement, and disability 21–23 …”

Section: Discussionmentioning

confidence: 99%

“…Research evidence of associations between CMP‐related PROMs and function changes of the ANS are limited to three studies with 10 or fewer minutes of heart rate variability (HRV) measures. Results found weak‐to‐moderate correlations between HRV parameters and perceived level of disability, catastrophizing, kinesiophobia, and symptoms of central sensitization 21–23 …”

Section: Objectivesmentioning

confidence: 99%

“…Results found weak-to-moderate correlations between HRV parameters and perceived level of disability, catastrophizing, kinesiophobia, and symptoms of central sensitization. [21][22][23] Heart rate variability refers to the temporal variation of beat-to-beat intervals between heartbeats. 24 A growing body of literature suggests that organized variability in the heart rate pattern is a reasonable index of physical and emotional health.…”

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confidence: 99%

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To what degree patient‐reported symptoms of central sensitization, kinesiophobia, disability, sleep, and life quality associated with 24‐h heart rate variability and actigraphy measurements?

Mikkonen,

Kupari,

Tarvainen

et al. 2023

Pain Practice

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ObjectivesChronic musculoskeletal pain is associated with decreased parasympathetic and increased sympathetic activity in the autonomic nervous system. The objective of this study was to determine the associations between objective measures of heart rate variability (a measure of autonomic nervous system function), actigraphy (a measure of activity and sleep quality), respiration rates, and subjective patient‐reported outcome measures (PROMs) of central sensitization, kinesiophobia, disability, the effect of pain on sleep, and life quality.MethodsThirty‐eight study subjects were divided into two subgroups, including low symptoms of central sensitization (n = 18) and high symptoms of central sensitization (n = 20), based on patient‐reported scores on the Central Sensitization Inventory (CSI). Heart rate variability (HRV) and actigraphy measurements were carried out simultaneously in 24 h measurement during wakefulness and sleep.ResultsA decrease in HRV during the first 2 h of sleep was stronger in the low CSI subgroup compared to the high CSI subgroup. Otherwise, all other HRV and actigraphy parameters and subjective measures of central sensitization, disability, kinesiophobia, the effect of pain on sleep, and quality of life showed only little associations.DiscussionThe high CSI subgroup reported significantly more severe symptoms of disability, kinesiophobia, sleep, and quality of life compared to the low CSI subgroup. However, there were only small and nonsignificant trend in increased sympathetic nervous system activity and poorer sleep quality on the high central sensitization subgroup. Moreover, very little differences in respiratory rates were found between the groups.

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Association of Muscle Strength, Psychological Factors, and Central Sensitization With Movement-Evoked Pain in Patients With Nonspecific Chronic Low Back Pain: The BACKFIT Project

Segura-Jiménez,

Tsiarleston,

Donoso

et al. 2024

Sports Health: A Multidisciplinary Approach

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Background: People with chronic pain might evade certain movements to prevent their experience of pain. Movement-evoked pain (MEP) might induce lower functionality during daily activities. Hypothesis: (1) MEP after physical fitness tests would vary depending on the main musculature involved in the test; (2) physical and psychological factors would be associated with MEP in patients with NSCLBP. Study Design: Cross-sectional design. Level of Evidence: Level 3. Methods: A total of 104 (69 women) patients aged 51.0 ± 10.3 years with NSCLBP participated. MEP was measured with a visual analog scale (VAS) at baseline and immediately after performing each physical fitness test, that is, the Biering-Sørensen, prone bridging, handgrip, chair-stand, and 8-foot time-up-and-go tests, measuring back extensor, back flexor, upper- and lower-body muscle strength, and motor agility, respectively. Global muscle strength was calculated with normalized index ( z-score) procedure. Depression, anxiety, pain catastrophizing, and central sensitization were assessed with the Beck Depression Inventory II, State Trait Anxiety Inventory I, Pain Catastrophizing Scale, and Central Sensitization Inventory (CSI), respectively. Results: Patients showed greater pain after completion of the Biering-Sørensen (mean difference 95% CI, 0.02, 1.11), prone bridging (0.15, 1.21), lower pain after handgrip (-1.46, -0.52), and the 8-foot time-up-and-go (-1.43, 0.46) tests (all P ≤ 0.04). Lower global muscular strength (β between -0.18 and -0.30), and greater pain catastrophizing (β = 0.16), and CSI scoring (β between 0.18 and 0.27) were associated with greater MEP (all P ≤ 0.04). Conclusion: Greater MEP was observed after tests measuring core musculature strength than after tests measuring distal (limbs) strength and agility. Greater MEP was overall associated with lower muscle strength, greater pain catastrophizing, and central sensitization. Clinical Relevance: Fitness testing might be implemented as a complementary tool for the monitoring of NSCLBP in clinical settings.

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Central sensitization and functioning in patients with chronic low back pain: A cross-sectional and longitudinal study

Cited by 6 publications

References 53 publications

Signs of Central Sensitization in Patients With Musculoskeletal Disorders and Chronic Comorbidities: A Systematic Review and Meta-Analyses of Observational Studies

Signs of Central Sensitization in Patients With Musculoskeletal Disorders and Chronic Comorbidities: A Systematic Review and Meta-Analyses of Observational Studies

To what degree patient‐reported symptoms of central sensitization, kinesiophobia, disability, sleep, and life quality associated with 24‐h heart rate variability and actigraphy measurements?

Association of Muscle Strength, Psychological Factors, and Central Sensitization With Movement-Evoked Pain in Patients With Nonspecific Chronic Low Back Pain: The BACKFIT Project

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