Department of Rehabilitation, Tanabe Orthopaedics, Osaka, Japan.
Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara, Hiroshima, Japan.
Pain Pract. 2021 Jul;21(6):646-652. doi: 10.1111/papr.13005. Epub 2021 Apr 3.
Increased evidence indicates that pain location affects central sensitization (CS)-related symptoms. In addition, pain location and pain duration may be intricately related to CS-related symptoms. However, these factors have been investigated separately. This study aimed to investigate the association between CS-related symptoms and pain location and/or pain duration in patients with musculoskeletal disorders.
Six hundred thirty-five participants with musculoskeletal disorders were included in this cross-sectional study. All participants were assessed for pain location, pain duration, central sensitization inventory (CSI), EuroQol-5 dimension, and brief pain inventory. The participants were categorized into 3 groups based on pain location (spinal, limb, and both spinal and limb pain) and into 2 groups based on pain duration (acute and chronic pain).
The interaction between pain location and pain duration were not significant on CSI score (P > 0.05). The odds ratio for higher CSI score (≥ 40) in patients with both spinal and limb pain vs. those with spinal or limb pain was 2.64 (P < 0.01) and that in patients with chronic pain vs. those with acute pain was 1.31 (P = 0.52). In addition, the prevalence of higher CSI scores in the combination of chronic and "both spinal and limb" pain was high (23.1%, adjusted residual = 4.48).
Pain location independently influenced CSI scores, and the combination of both spinal and limb pain and chronic pain indicated high CSI scores. The combination of pain location and pain duration is an important clue that points to CS-related symptoms.
越来越多的证据表明，疼痛部位会影响与中枢敏化（CS）相关的症状。此外，疼痛部位和疼痛持续时间可能与 CS 相关症状密切相关。然而，这些因素尚未同时进行研究。本研究旨在调查与 CS 相关的症状与骨骼肌肉疾病患者的疼痛部位和/或疼痛持续时间之间的关联。
本横断面研究纳入了 635 名骨骼肌肉疾病患者。所有患者均评估了疼痛部位、疼痛持续时间、中枢敏化量表（CSI）、欧洲五维健康量表（EQ-5D）和简明疼痛量表（BPI）。根据疼痛部位（脊柱、四肢和脊柱及四肢疼痛）将患者分为 3 组，根据疼痛持续时间（急性和慢性疼痛）将患者分为 2 组。
疼痛部位和疼痛持续时间之间的交互作用对 CSI 评分无显著影响（P＞0.05）。与脊柱或四肢疼痛患者相比，脊柱和四肢疼痛患者的 CSI 评分较高（≥40）的优势比为 2.64（P＜0.01），慢性疼痛患者的优势比为 1.31（P=0.52）。此外，慢性疼痛与“脊柱和四肢”疼痛并存的患者中较高 CSI 评分的发生率较高（23.1%，调整残差=4.48）。
疼痛部位独立影响 CSI 评分，脊柱和四肢疼痛并存以及慢性疼痛表明 CSI 评分较高。疼痛部位和疼痛持续时间的组合是指向 CS 相关症状的重要线索。
