Central sensitization patients present different characteristics compared with other musculoskeletal patients: A case–control study

Abstract

The aims of this study were to identify the prevalence of a clinical dominance of musculoskeletal pain type and to compare pain characteristics among patients with musculoskeletal disorders. A case-sectional study was conducted at a physiotherapy outpatient service in 149 consecutive patients with complaints of musculoskeletal pain. Participants completed a sociodemographic and pain characteristics questionnaire. The dominance of nociceptive (NO), peripheral neuropathic (PN) and central sensitization (CS) mechanisms of musculoskeletal pain was based on clinical classification. The most prevalent clinical predominance was NO pain (53.57%), followed by PN (25.00%) and CS (21.43%). Age, gender and sedentary behaviour did not show differences between pain groups. Patients with CS predominance had a higher number of separated areas (CS 8.1 vs NO 3.0 vs PN 4.9; p < 0.001) and widespread pain (CS 0.52 cm² vs NO 0.14 cm² vs PN 0.28 cm²; p = 0.001). Patients with CS predominance had an average pain intensity of 7.90, and the majority of patients were classified as having severe pain. In conclusion, patients with a predominance of CS pain showed higher pain intensity, pain duration and number of pain areas and more widespread pain than those with PN and NO. Chronicity of pain is not sufficient to distinguish CS predominance.

Keywords:

• Central nervous system sensitization
• chronic pain
• musculoskeletal pain
• physical therapy specialty