Central Sensitization and Altered Central Pain Processing in Chronic Low Back Pain: Fact or Myth?

  title={Central Sensitization and Altered Central Pain Processing in Chronic Low Back Pain: Fact or Myth?},
  author={Nathalie Anne Roussel and Jo Nijs and Mira Meeus and Veit Mylius and C{\'e}cile Fayt and Rob A.B. Oostendorp},
  journal={The Clinical Journal of Pain},
Objective:The purpose of this narrative review is to analyze the available literature concerning central sensitization and altered central pain processing in patients with chronic low back pain (LBP). Methods:Literature was screened using several electronic search databases. Additional literature was obtained by reference tracking and expert consultation. Studies evaluating central pain processing in conservatively treated patients with chronic LBP were included. Results:Results of studies… 
Central sensitization and changes in conditioned pain modulation in people with chronic nonspecific low back pain: a case–control study
There was no significant difference in PPTs in men between healthy controls and those with low back pain, suggesting the significant differences are mediated primarily by difference between women.
Contributions of Mood, Pain Catastrophizing, and Cold Hyperalgesia in Acute and Chronic Low Back Pain: A Comparison With Pain-free Controls
Evidence for localized and generalized cold hyperalgesia in chronic, but not acute LBP is found, and it is speculated that hyperAlgesia develops as a consequence of long-lasting LBP, but prospective studies are needed to confirm this assumption.
The relationship between catastrophizing and altered pain sensitivity in patients with chronic low-back pain
Not only do patients with cLBP demonstrate increased pain sensitization and decreased sensitivity to innocuous stimuli, but these changes are also linked with increased catastrophizing, which is associated with increased clinical pain among patients withcLBP.
Low back pain: guidelines for the clinical classification of predominant neuropathic, nociceptive, or central sensitization pain.
The pain classification system for L BP should be an addition to available classification systems and diagnostic procedures for LBP, as it is focussed on pain mechanisms solely.
A Subgroup of Chronic Low Back Pain Patients With Central Sensitization
Background: Our knowledge of central sensitization (CS) in chronic low back pain (CLBP) is limited. 2011 fibromyalgia criteria and severity scales (2011 FM survey) have been used to determine FM
Alterations in pro-nociceptive and anti-nociceptive mechanisms in patients with low back pain: a systematic review with meta-analysis.
Ipaired CPM and facilitated TSP was present in LBP patients compared to controls, though the magnitude of differences was small which may direct future research on the clinical utility.
Central sensitization in chronic low back pain: A narrative review.
The purposes of this narrative review are to describe central sensitization and its symptoms and signs in patients with chronic pain disorders in order to allow its recognition in Patients with nonspecific low back pain.
Nonoperative treatment for pain sensitization in patients with low back pain: protocol for a systematic review
A systematic review of RCTs evaluating the effectiveness and safety of nonoperative treatment for pain sensitization in patients with low back pain aims to provide evidence regarding which treatment provides the greatest benefit forPain sensitization and safety among patients withLow back pain.


Evidence of augmented central pain processing in idiopathic chronic low back pain.
At equal levels of pressure, patients with CLBP or fibromyalgia experienced significantly more pain and showed more extensive, common patterns of neuronal activation in pain-related cortical areas, consistent with the occurrence of augmented central pain processing in patients with idiopathic CLBP.
Treatment of central sensitization in patients with ‘unexplained’ chronic pain: what options do we have?
This article provides an overview of the treatment options available for desensitizing the CNS in patients with chronic pain due to central sensitization, and focuses on those strategies that specifically target pathophysiological mechanisms known to be involved incentral sensitization.
Central Processing of Acute Muscle Pain in Chronic Low Back Pain Patients: An EEG Mapping Study
  • M. Diers, C. Koeppe, H. Flor
  • Psychology, Medicine
    Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
  • 2007
Results indicate enhanced perceptual sensitization and enhanced processing of the sensory-discriminative aspect of pain, as expressed in the N80 component, in CLBP patients, and may be related to the affective distress observed in this patient group.
Pain sensitivity as a correlate of clinical status in individuals with chronic low back pain.
Pilot data suggest that an individual's experimental pain threshold (a measure of tenderness) is associated with baseline functional status and pain in cases of chronic low back pain and may represent an important domain warranting further investigation.
Chronic Pain and the Emotional Brain: Specific Brain Activity Associated with Spontaneous Fluctuations of Intensity of Chronic Back Pain
It is suggested that subjective spontaneous pain of CBP involves specific spatiotemporal neuronal mechanisms, distinct from those observed for acute experimental pain, implicating a salient role for emotional brain concerning the self.
Evidence of involvement of central neural mechanisms in generating fibromyalgia pain
  • R. Staud
  • Medicine, Biology
    Current rheumatology reports
  • 2002
Brain images have corroborated the augmented reported pain experience of patients with fibromyalgia during experimental pain stimuli and thalamic activity, which contributes significantly to pain processing, was decreased in Fibromyalgia.