Proportion and characteristics of new patients with central sensitization presenting to a chiropractic practice-a cross-sectional observational study

Abstract

Central Sensitization (CS) is postulated as a central explanation of chronic pain. Clinical researchers recommend that therapists screen for CS to avoid diagnostic confusion and improve the allocation of appropriate clinical resources in primary care settings when managing chronic pain patients. However, the percentage of patients presenting with CS to a chiropractic practice has not been found in the literature. This study had two objectives: to use the Central Sensitization Inventory (CSI) to screen for and identify the proportion and characteristics of consecutive new patients with chronic pain conditions and medically unexplained symptoms who are experiencing CS; and to determine if there were significant clinical relationships between patient characteristics (age, sex, BMI, complaint type and duration, balance issues and presence of comorbid overlapping CS syndromes) and CSI scores. Results indicated that 1 in 5 adult new patients may have experienced CS. ANOVA analysis revealed significant difference between fibromyalgia and chronic spinal pain patients; significant difference due to subjective dizziness; significant difference between the number of positive answers in the CSI-Part B for the CSI>40 subjects and subjects with 2 or more positive answers on CSI Part B compared to those with none/one positive answer. Chiropractors should consider using a validated CS screening tool, such as the CSI, for all new patients, and implementing adjunctive, evidence-based CS clinical management strategies.