Bio Psychosocial Factors and Central Sensitization in Patients with Chronic Musculoskeletal Pain

Abstract

Introduction: Central sensitization (CS) is a neurological sensitivity phenomenon that causes patients to perceive more pain and broader discomfort. However, the bio psychosocial factors associated with the phenomenon of perception continue to explore and further the current knowledge on CS in patients with chronic musculoskeletal pain. The main purpose of this study was to determine the extent of associative relationship between central nervous system sensitization and bio psychosocial measures in patients with chronic musculoskeletal pain. Settings and Design: An observational cross-sectional study was carried out in a tertiary care hospital’s outpatient unit. Methods and Materials: Two hundred patients with chronic musculoskeletal pain were included in the present cross-sectional study. They completed questionnaires such as Central sensitisation inventory (CSI), Tampa Scale of Kinesiophobia (TSK), Pain Catastrophizing index (PCI), Insomnia Severity Index (ISI), Widespread Pain Index (WPI), Symptom Severity Score (SS), Kessler Psychological Distress Scale (K10 SCORE) and Fatigue Severity Scale (FSS). Results: The bio psychosocial factors showed mild to moderate correlation with CSI score ,FSS (r=0.432); TSK (r=0.432); K10 score (r=0.450);PCI score (r=0.465); Total (WPI+SS) score (r=0.467) and ISI score(r=0.249).These bio psychosocial factors in a statistically significant hierarchical regression model showed 37.9 % variance on CSI score (F- 31.39;P< 0.001) where kinesiophobia and Insomnia did not satisfy the model fit. Conclusion: Even the CS showed a significant association with bio psychosocial factors, it kept kinesiophobia and Insomnia out in its variance contribution.