The Definition, Assessment, and Prevalence of (Human Assumed) Central Sensitisation in Patients with Chronic Low Back Pain: A Systematic Review

Abstract

Central sensitisation is assumed to be one of the underlying mechanisms for chronic low back pain. Because central sensitisation is not directly assessable in humans, the term ‘human assumed central sensitisation’ (HACS) is suggested. The objectives were to investigate what definitions for HACS have been used, to evaluate the methods to assess HACS, to assess the validity of those methods, and to estimate the prevalence of HACS. Database search resulted in 34 included studies. Forty different definition references were used to define HACS. This review uncovered twenty quantitative methods to assess HACS, including four questionnaires and sixteen quantitative sensory testing measures. The prevalence of HACS in patients with chronic low back pain was estimated in three studies. The current systematic review highlights that multiple definitions, assessment methods, and prevalence estimates are stated in the literature regarding HACS in patients with chronic low back pain. Most of the assessment methods of HACS are not validated but have been tested for reliability and repeatability. Given the lack of a gold standard to assess HACS, an initial grading system is proposed to standardize clinical and research assessments of HACS in patients with a chronic low back.

Joint pathology in musculoskeletal lumbar pain: a dialogue between a neurologist and a rheumatologist

“…Для диагностики этой «составляющей» используют различные опросники (CSI (Central sensitization inventory), HADS (Hospital Anxiety and Depression Scale) и др. ), тщательный опрос и осмотр пациента для выявления гипералгезии, распространенной боли, депрессии и тревоги [17,18].…”

Analgesics in rheumatic diseases – a necessary component of therapy aimed at improving the quality of life

“…При ОА тазобедренного сустава распространенность высоковероятной невропатической боли по опроснику PainDETECT достигала 9% (95% ДИ 6-13%); ЦС по опроснику CSI -29% (95% ДИ 11-36%). Весьма часто признаки ЦС определялись и при хронической НБС: согласно результатам метаанализа 16 исследований (n=2347), число пациентов со счетом CSI ≥40 при данной патологии составляет 43,2% [37].…”

Does a combination of self‐reported signs related to central sensitization and pressure pain threshold allow for a more detailed classification of pain‐related characteristics in patients with chronic musculoskeletal pain?: A cross‐sectional study

“…[11][12][13] Although the existence and degree of CS cannot be proven with direct electrophysiological recordings, as has been reported in animal studies, clinical practice, and research, various measurement methods, such as quantitative sensory testing (QST), (functional) magnetic resonance imaging, measurements of cytokines and neurotrophines (eg, tumor necrosis factorα, nerve growth factor, and brain-derived neurotrophic factor), and questionnaires have been used for assessing various phenomena that indicate altered central pain processing. 14,15 Although the best method for assessing CS is not yet known, QST is considered the optimal method as a neurophysiological measurement of CS. 16 Among the various QST modalities, the pressure pain threshold (PPT) at the painful site and/or sites remote from the painful region have been frequently used in patients with chronic pain.…”