CSI and Musculoskeletal Pain: Clinical Validity and Neurophysiological Implications.

BACKGROUND AND AIM: Chronic pain affects about 20% of adults worldwide, severely impacting quality of life and functioning. Many chronic pain syndromes share symptoms such as fatigue, poor sleep, anxiety, and depression, suggesting a common mechanism. Central sensitization, an abnormal amplification of pain by the nervous system, is considered a key underlying factor. Assessment tools like the Central Sensitization Inventory (CSI) and laser-evoked potentials (LEPs) may improve diagnosis and guide targeted treatment strategies. This review evaluates the validity of the CSI for assessing central sensitization in chronic musculoskeletal pain. It also explores integrating objective measures like LEPs to enhance diagnosis and treatment strategies.

METHODS

A systematic review was conducted following PRISMA guidelines. Searches in PubMed, Web of Science, Cochrane Library, Embase, and Scopus included studies published before September 2025. After removing duplicates and non-English articles, titles and abstracts were screened, and full texts assessed for eligibility. Study quality was evaluated using the JBI checklists.

RESULTS

From 557 retrieved studies, 8 met the inclusion criteria. All used the CSI, showing it as a valid and practical tool correlating with pain, disability, and impaired quality of life. However, limitations due to its subjective nature were noted.

CONCLUSIONS

While CSI is valuable for initial screening, combining it with LEPs can provide a more precise and comprehensive assessment, improving diagnosis, management, and treatment personalization.