• Jo Nijs, Rafael Torres-Cueco, C Paul van Wilgen, Enrique Lluh Girbes, Filip Struyf, Nathalie Roussel, Jessica van Oosterwijck, Liesbeth Daenen, Kevin Kuppens, Luc Vanwerweeen, Linda Hermans, David Beckwee, Lennard Voogt, Jacqui Clark, Niamh Moloney, and Mira Meeus.
• Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgiu.
• Pain Physician. 2014 Sep 1; 17 (5): 447-57.

BackgroundThe awareness is growing that central sensitization is of prime importance for the assessment and management of chronic pain, but its classification is challenging clinically since no gold standard method of assessment exists.ObjectivesDesigning the first set of classification criteria for the classification of central sensitization pain.MethodsA body of evidence from original research papers was used by 18 pain experts from 7 different countries to design the first classification criteria for central sensitization pain.ResultsIt is proposed that the classification of central sensitization pain entails 2 major steps: the exclusion of neuropathic pain and the differential classification of nociceptive versus central sensitization pain. For the former, the International Association for the Study of Pain diagnostic criteria are available for diagnosing or excluding neuropathic pain. For the latter, clinicians are advised to screen their patients for 3 major classification criteria, and use them to complete the classification algorithm for each individual patient with chronic pain. The first and obligatory criterion entails disproportionate pain, implying that the severity of pain and related reported or perceived disability are disproportionate to the nature and extent of injury or pathology (i.e., tissue damage or structural impairments). The 2 remaining criteria are 1) the presence of diffuse pain distribution, allodynia, and hyperalgesia; and 2) hypersensitivity of senses unrelated to the musculoskeletal system (defined as a score of at least 40 on the Central Sensitization Inventory).LimitationsAlthough based on direct and indirect research findings, the classification algorithm requires experimental testing in future studies.ConclusionClinicians can use the proposed classification algorithm for differentiating neuropathic, nociceptive, and central sensitization pain.

15 keywords...

hide…