Central Sensitization Inventory is a useless instrument for detection of the impairment of the conditioned pain modulation in patients with chronic musculoskeletal pain

Bezerra, Márcia Cliton; Bittencourt, Juliana Valentim; Reis, Felipe José Jandre dos; Almeida, Renato Santos de; Meziat‐Filho, Ney; Nogueira, Leandro Alberto Calazans

doi:10.1016/j.jbspin.2020.105127

Cited by 20 publications

(14 citation statements)

References 30 publications

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“…Looking at the subgroups (acute and chronic LBP) our study showed significant differences between both acute and chronic LBP compared with PFC 13. The results of the second aim are in line with the study of Cliton Bezerra et al41 and Kregel et al42 Their study showed a weak associations between the CSI total scores and PPT measurements42 and no associations between the CSI total scores and CPM measurement 41,42. Despite the fact that in our study no significant difference was found for the CPM measurements between the “CS” group and “no-CS” group effects sizes varied from “small” to “small to medium.” It turns out that something in the somatosensory system changes in the processing of stimuli.…”

Section: Discussionsupporting

confidence: 90%

Differences in Quantitative Sensory Testing Outcomes Between Patients With Low Back Pain in Primary Care and Pain-free Controls

Bandt

Ickmans

Leemans

et al. 2022

The Clinical Journal of Pain

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Objectives: Quantitative Sensory Testing (QST) is used to test somatosensory functioning in on people with chronic LBP in secondary/ tertiary health care facilities. Studies using QST-testing on LBP populations in primary care are scarce. Central Sensitization Inventory (CSI) measures central sensitization (CS)-related symptoms and studies investigating the differences between QST-testing and participants with LBP with a positive and negative score on the CSI questionnaire are also rare. This case-control study investigates differences of an extensive QST-measurement between patients with acute, chronic LBP, and pain-free controls (PFCs) in primary care. Secondary aim is to investigate differences of an extensive QST-measurement between "CS" and "no-CS" group.Materials and Methods: Participants with LBP were recruited from November 2016 to October 2019. Demographic and clinical information was collected and a standardized QST protocol was taken. Data analysis involved determining differences between groups.Results: Data of 100 participants with LBP and 50 PFCs were analyzed. Heat pain thresholds, pressure pain threshold, and conditioned pain modulation local and remote were significantly moderately to relatively strongly affected by acute, chronic LBP and PFCs (P < 0.001 to 0.001). Lumbar temporal summation was significantly moderately affected by acute, chronic LBP, and PFCs (P = 0.001). Only pressure pain threshold showed significant difference between "CS" and "no-CS" group (P = 0.001 to 0.002).Discussion: Signs of enhanced nociceptive processing and disturbed top-down nociceptive modulation are apparent in people with acute and chronic LBP in primary care. Results indicate existence of central mechanisms in LBP in primary care.

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Section: Discussionsupporting

confidence: 90%

Differences in Quantitative Sensory Testing Outcomes Between Patients With Low Back Pain in Primary Care and Pain-free Controls

Bandt

Ickmans

Leemans

et al. 2022

The Clinical Journal of Pain

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“…Te CSI [70] is a valid and reliable questionnaire [71] to quantify the severity of central sensitization symptoms in patients with chronic pain [22]. Te CSI is also not correlated with changes in pain sensitivity measured with quantitative sensory testing [72,73].…”

Section: Characteristics Of Patients With Lbp Presenting With Nppmentioning

confidence: 99%

Characteristics and Outcomes of Patients Receiving Physical Therapy for Low Back Pain with a Nociplastic Pain Presentation: A Secondary Analysis

Wilson

Riley

Bishop

et al. 2023

Pain Research and Management

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Introduction. Individuals with low back pain (LBP) may be classified based on mechanistic descriptors, such as a nociplastic pain presentation (NPP). The purpose of this secondary analysis was to examine the frequency and characteristics of patients with a NPP referred to physical therapy with LBP. Additionally, we characterized patients with LBP meeting the criteria for NPP by demographic, clinical, psychological, and pain sensitivity variables. Finally, we examined short- and long-term clinical outcomes in patients with a NPP compared to those without a NPP. Materials and Methods. Patients referred to physical therapy for LBP completed the Patient Self-report Survey for the Assessment of Fibromyalgia. Participants were categorized as “LBP with NPP” or “LBP without NPP” based on the threshold established in this measure. A rank sum test examined for differences in pain-related psychological factors and pressure-pain threshold between groups. Next, a Friedman test examined if LBP intensity and disability trajectories differed by groups at one and six months after initiation of physical therapy. Results. 22.2% of patients referred to physical therapy for LBP met the criteria for a NPP. Patients with a NPP reported significantly greater disability, pain catastrophizing, depression, anxiety, and somatization compared to individuals without a NPP ( p < 0.05 ). Pressure-pain threshold did not differ between groups ( p > 0.05 ). Individuals with LBP with a NPP demonstrated nonsignificant, small to medium reductions in pain and disability at one and six months. Individuals experiencing LBP without a NPP demonstrated significant reductions in pain and disability in the short- and long term. Conclusion. Patients with LBP with a NPP displayed greater negative pain-related psychological factors but similar pain sensitivity compared to LBP without NPP.

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“…This may have caused the CSI score in the current study to not only evaluate symptoms related to altered central somatosensory functioning, but also factors directly related to cancer treatment that are not (only) associated with altered central somatosensory functioning. Furthermore, one might question if the CSI actually evaluates somatosensory functioning at the neurophysiological level, considering the literature in both cancer and musculoskeletal pain populations describing a weak association between QST methods designed to evaluate central somatosensory functioning and CSI results (Bezerra et al, 2020; Caumo et al, 2017; Coronado & George, 2018; Dams et al, 2022; Gervais‐Hupé et al, 2018; Kregel et al, 2018; Moore et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of pain neuroscience education on somatosensory functioning after surgery for breast cancer: A double‐blinded randomized controlled trial

Dams

Gucht

Haenen

et al. 2023

The Anatomical Record

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Pain is one of the most prevalent and long‐term adverse effects described by people who have undergone breast cancer surgery. Non‐helpful perceptions and thoughts about pain may contribute to the transition of acute to persistent pain. Adding educational interventions to the current physical therapy program in this population may help to improve or prevent persistent pain. Pain neuroscience education (PNE) is a type of educational intervention that addresses the experience of pain in a broader sense by explaining pain not only from a biomedical perspective, but also from a psychological and social perspective. A double‐blinded randomized controlled trial (EduCan trial) investigated whether PNE, in addition to a standard physiotherapy program immediately after surgery for breast cancer, was more effective on somatosensory functioning in the short (4 months postoperatively) and long term (18 months postoperatively), than providing a biomedical explanation for pain. Somatosensory functioning was evaluated using a self‐reported questionnaire as well as a comprehensive quantitative sensory testing evaluation. The findings of this study revealed that adding six sessions of PNE to a standard physical therapy program (n = 184) did not result in a significantly different course of somatosensory functioning up to 18 months postoperatively as compared to biomedical pain education. These findings provide an interesting basis for future research into who should receive PNE after surgery for breast cancer (e.g., patient profiling or phenotyping) and how we can tailor it to the individual to increase its effectiveness.

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Central Sensitization Inventory is a useless instrument for detection of the impairment of the conditioned pain modulation in patients with chronic musculoskeletal pain

Cited by 20 publications

References 30 publications

Differences in Quantitative Sensory Testing Outcomes Between Patients With Low Back Pain in Primary Care and Pain-free Controls

Differences in Quantitative Sensory Testing Outcomes Between Patients With Low Back Pain in Primary Care and Pain-free Controls

Characteristics and Outcomes of Patients Receiving Physical Therapy for Low Back Pain with a Nociplastic Pain Presentation: A Secondary Analysis

Effectiveness of pain neuroscience education on somatosensory functioning after surgery for breast cancer: A double‐blinded randomized controlled trial

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