Central sensitisation in chronic low back pain: A cross-sectional study.

Abstract

Background and aims: Central sensitisation (CS) is a key mechanism contributing to chronic low back pain (CLBP), influenced by demographic, metabolic, and psychological factors. This study aimed to evaluate the association between CS and variables such as age, gender, body mass index (BMI), vitamin D levels, psychological distress (anxiety, depression, kinesiophobia), and pain intensity in individuals with CLBP.

Methods: A cross-sectional observational study was conducted at a tertiary care centre between January and December 2023. Adults aged 18 years or older with CLBP (lasting at least 3 months) were included. Participants were assessed using the Central Sensitisation Inventory (CSI), Numerical Rating Scale (NRS), Tampa Scale for Kinesiophobia, BMI, and serum vitamin D levels. Individuals with neurological or psychiatric disorders or those on medications affecting pain modulation were excluded. Statistical analysis was performed using non-parametric tests and Spearman's correlation to explore associations between CSI scores and demographic, metabolic, and psychological variables. P value < 0.05 was considered statistically significant.

Results: The mean age of participants was 41.3 years. Females had significantly higher CSI scores than males (P < 0.001). CSI scores differed significantly across age groups (P = 0.024), with the highest scores observed in participants under 20 years of age. Weak correlations were observed between CSI scores and both BMI and vitamin D levels. BMI showed a weak positive correlation with CSI scores (ρ = 0.182, P = 0.036), while vitamin D levels showed a weak negative correlation with CSI scores (ρ = -0.181, P = 0.038). No significant associations were found between CSI scores and anxiety, depression, kinesiophobia, or pain intensity.

Conclusion: CS in CLBP is associated with age, gender, BMI, and vitamin D levels, but not psychological distress or pain intensity. These findings highlight the importance of personalised, multidimensional pain assessment and management approaches.