Characterizing clinical progression in patients with musculoskeletal pain by pain severity and central sensitization-related symptoms

Abstract

Central sensitization-related symptoms (CSS) are associated with the severity and progression of pain. The relationship between the severity of pain/CSS and clinical progresses remains unclear. This multicenter, collaborative, longitudinal study aimed to characterize the clinical outcomes of patients with musculoskeletal pain by classifying subgroups based on the severity of pain/CSS and examining changes in subgroups over time. We measured the pain intensity, CSS, catastrophic thinking, and body perception disturbance in 435 patients with musculoskeletal pain. Reevaluation of patients after one month included 166 patients for pain intensity outcome and 110 for both pain intensity and CSS outcome analysis. We classified the patients into four groups (mild pain/CSS, severe pain/mild CSS, severe pain/CSS, and mild pain/severe CSS groups) and performed multiple comparison analyses to reveal the differences between the CSS severity groups. Additionally, we performed the adjusted residual chi-square to identify the number of patients with pain improvement, group transition, changing pain, and CSS pattern groups at baseline. The most characteristic result was that the mild and severe CSS groups showed worsening pain. Moreover, many of the group transitions were to the same group, with a few transitioning to a group with mild pain/CSS. Our findings suggest that the severity and improvement of CSS influence pain prognosis.

Description of pain associated with persistent postoperative pain after total knee arthroplasty

“…It remains to be clarified whether the same description of pain as at 2 weeks postoperatively was continued to be used. Future studies could analyze these associations by assessing catastrophic thinking 37 – 39 , anxiety and depression 40 , central sensitization-related symptoms 36 , 39 , 41 , 42 , and neuropathic pain 7 , as well as by examining pain descriptions at 3 and 6 months. Third, central/peripheral neuromuscular activity measurements, such as functional magnetic resonance imaging, motor-evoked potentials, and electromyography, were not performed.…”