Severity of central sensitization in patients with chronic low back pain

Abstract

Background: Low back pain develops into Chronic Low Back Pain (CLBP) due to the contribution of various psychosocial factors in approximately 10-20% of all patients. CLBP is classified into three groups namely neuropathic, nociceptive and central sensitization (CS). CS results in pain due to hyper-responsive nociceptive neurons and recruitment of sub-threshold or normal stimuli.

Objective: To determine the frequency of central sensitization in patients with chronic low back pain

Methods: A descriptive cross-sectional observational study was conducted on 388 patients with CLBP, aged between 18 to 44 years, using non-probability convenient sampling. Patients were recruited from Ghurki Trust and Teaching Hospital, whereas, adults with a history of spinal surgery within the last 12 months, use of NSAIDs/analgesics, and coexisting neurological, respiratory, cardiac, or rheumatic disorder were excluded. The participants were requested to fill the Central Sensitization Inventory (CSI) questionnaire which has a test-retest reliability of 0.817.

Results: Out of 388 participants, 22.7% (n=88) of the participants demonstrated subclinical central sensitization. Mild central sensitization was reported by 33.0% (n=128) participants, 20.6% (n=80) demonstrated moderate central sensitization scores on the CSI. Whereas, severe central sensitization was found in 13.4% (n=52) participants and 10.3% (n=40) of the participants reported extreme central sensitization category based on their scores on the CSI.

Conclusion: Mild central sensitization was reported frequently among patients with chronic low back pain.