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Please use this identifier to cite or link to this item: http://hdl.handle.net/11055/1111
Title: Can Central Sensitization after injury persist as an autonomous pain generator? - A comprehensive search for evidence
Authors: Brazenor, Graeme A
Malham, Gregory M
Teddy, Peter J
ANZCA/FPM Author: Teddy, PJ
Keywords: Central sensitization
central sensitization diagnosis
chronic pain
Citation: 2021 Oct 29;pnab319 Online ahead of print.
Abstract: Objective: To conduct a comprehensive search for evidence whether Central Sensitization following an injury can act as a persistent autonomous pain generator after the inducing injury has healed. Methods: We searched Medline on PubMed and the Cochrane Library, screening 3,572 abstracts, from which 937 full text articles were obtained, with 186 of these discarded as irrelevant to the question being posed. The remaining 751 articles were studied for evidence. Results: Fourteen publications were judged to provide weak evidence for the hypothesis of central sensitization as a persisting autonomous pain generator, but none addressed the question directly. No strong evidence for the affirmative answer was found. Sixty-two publications were judged to provide weak evidence for a negative answer, and nine judged to provide strong evidence. Unexpectedly, serious weaknesses were discovered in the literature underpinning the validity of the clinical diagnosis of Central Sensitization in man:(i) Inappropriate extrapolation, in many publications, of laboratory animal data to humans.(ii) Failure to demonstrate the absence of peripheral pain generators which might be perpetuating Central Sensitization.(iii) Many factors now shown to confound what is being measured by quantitative sensory testing, conditioned pain modulation, and Central Sensitization Inventory. Conclusions: We found no evidence proving that central sensitization can persist as an autonomous pain generator after the initiating injury has healed. Our review has also shown that the evidential basis for the diagnosis of CS in individual patients is seriously in question.
URI: http://hdl.handle.net/11055/1111
DOI: 10.1093/pm/pnab319
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/34718773/
ISSN: 1526-4637
Journal Title: Pain Medicine
Type: Journal Article
Study/Trial: Case Control Studies
Appears in Collections:Scholarly and Clinical

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