Difference in the impact of central sensitization on pain-related symptoms between patients with chronic low back pain and knee osteoarthritis

Akira Mibu,1 Tomohiko Nishigami,1 Katsuyoshi Tanaka,2 Masahiro Manfuku,3 Satoko Yono21Department of Nursing and Physical Therapy, Konan Women’s University, Kobe, Hyogo, Japan; 2Department of Rehabilitation, Tanabe Orthopaedics, Osaka, Japan; 3Department of Rehabilitation, Breast Care Sensyu Clinic, Kishiwada, Osaka, JapanPurpose: The aims of the present study were to investigate whether the association between the Central Sensitization Inventory (CSI) score, pain-related symptoms, pain-related disability, and health-related quality of life differed by disease (chronic low back pain [CLBP] vs knee osteoarthritis [KOA]), and to determine optimal cutoff scores for the CSI reflecting disease-specific characteristics.Patients and methods: A total of 104 patients with CLBP and 50 patients with KOA were recruited. Central sensitization-related symptoms (CSI), EuroQol 5-dimension (EQ-5D), Brief Pain Inventory, widespread pain (Widespread Pain Index [WPI]), pressure pain threshold (PPT), and temporal summation (TS) were assessed and compared between the CLBP and KOA groups. Univariate correlation analysis was performed in each group. The receiver operating characteristic (ROC) curve analysis was performed to identify 1) presence/absence of central sensitization (CS), 2) presence/absence of central sensitivity syndromes (CSSs), and 3) pain intensity and pain interference in each group.Results: The CSI and WPI scores were significantly higher in the CLBP group than in the KOA group. EQ-5D and pain interference scores significantly correlated with the CSI score in both the CLBP and KOA groups. The WPI score, PPT, and TS did not correlate with the CSI score in either the CLBP or KOA group. The suggested cutoff scores were 28 in the CLBP group and 17 in the KOA group to identify presence or absence of CSSs, and 34 in the CLBP group and 18–19 in the KOA group to identify pain severity.Conclusion: The impact of CS on pain could differ between CLBP and KOA and that cutoff scores differ by each parameter we attempted to identify. Therefore, we should use the appropriate cutoff scores for the purposes and consider the difference in the impact of CS on pain by the patient group.Keywords: central sensitization, chronic low back pain, knee osteoarthritis, cutoff score