article · BMC Musculoskeletal Disorders
Central sensitisation is increasingly identified as an important element in chronic pain disorders, yet its specific involvement and associated variables in knee osteoarthritis and chronic low back pain require clearer definition. A cross-sectional study evaluated 178 individuals with knee osteoarthritis and 118 with chronic low back pain using questionnaires and physical performance assessments. Measurements examined central sensitisation inventory scores alongside pain intensity, disability measures, physical capacity, and psychosocial factors including depression, anxiety, and pain catastrophising. Central sensitisation scores were significantly associated with greater pain intensity and disability across both patient cohorts. The scores also exhibited strong links with depression, anxiety, and pain catastrophising, with depression acting as a significant predictor of central sensitisation symptoms in both conditions.
Chronic joint and back pain are major sources of long-term disability. Demonstrating that nervous system hypersensitivity is linked to pain, physical limitation, and emotional distress highlights the need to consider psychological well-being when assessing and managing these widespread musculoskeletal disorders.
This clinical observational research indicates that evaluating central sensitisation and psychological distress could aid clinicians in assessing chronic pain conditions. However, the study remains early-stage observational research, and the abstract does not indicate a specific commercial technology, product, or clear application pathway.
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BACKGROUND: Central sensitization (CS) is becoming increasingly recognized as a significant factor in many chronic pain conditions, including knee osteoarthritis (KOA) and chronic low back pain (CLBP). Yet it presently remains unclear how strong is the involvement of CS in KOA and CLBP and which factors are involved in CS in these two chronic disabling diseases. METHODS: This is a cross-sectional study in which included a total of 178 patients with KOA and 118 patients with CLBP. Inclusion criteria for eligible participants for the KOA group were a confirmed diagnosis of KOA according to the American College of Rheumatology criteria, and for the CLBP group a chronic low back pain for more than 3 months. Subjects were excluded if they presented with a diagnosed psychiatric disorder or if they lacked the capacity to provide informed consent, understand study questionnaires or perform physical performance tests. In each group, were assessed; CS-related symptoms using the Central Sentization Inventory (CSI); demographic and clinical characteristics such as disease duration, pain intensity on a visual analog scale, self-reported function using the Lequesne index for KOA patients and the Oswestry Disability index for CLBP patients, and physical performance with the 6 minutes' walk test; as well as psychosocial risk factors using the Patient Health Questionnaire for depression (PHQ-9), the Generalized Anxiety Disorder (GAD-7) and the Pain Catastrophizing Scale (PCS). RESULTS: CSI scores significantly correlated with pain intensity and disability in KOA and CLBP patients, and were highly correlated with self-reported symptoms of depression, anxiety and pain catastrophizing. Depression significantly predicted the CSI score in both groups. CONCLUSION: These findings provide further evidence for the impact of CS on pain, function and physical performance in KOA and CLBP patients. Psychosocial symptoms such as pain catastrophizing, anxiety and depression should also be considered as they are also associated with CS.
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DOI: 10.1186/s12891-023-07019-z
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