RESUMEN
Background: Central sensitization (CS) is a state of heightened sensitivity of the central nervous system to both noxious and non-noxious stimuli. The Central Sensitization Inventory (CSI) is a sound screening tool to help clinicians to detect patients with CS. To date, no Gujarati version exists. Objectives: The aim of this study was to translate and cross-culturally adapt the CSI into Gujarati, and to check content validity, face validity, internal consistency, test-retest reliability, agreement and minimum detectable change (MDC) of CSI-G in chronic low back pain (CLBP) patients. Methods: Translation and cross-cultural adaptation of the original English version of the CSI-G was performed according to published guidelines. The content validity was ascertained by 23 healthcare professionals. The internal consistency, test-retest reliability, agreement and MDC was determined on CLBP patients (n=31) with a time interval of 7-days. Results: The content validity and Face validity was found to be excellent. The internal consistency was excellent (Cronbach’s α=0.914) and MDC was found to be 5.092 points. The test-retest reliability showed very high correlation in CLBP patients (ICC = 0.971). Conclusion: The original CSI was translated into Gujarati and did not pose any problems during data acquisition. The CSI-G seems to be reliable instruments to measure CS in Gujarati patients with CLBP. [Bid D NJIRM 2016; 7(5):18-24]
RESUMEN
Objective: The aim of this narrative review is to examine the available literature related to central sensitization (CS) and altered central pain processing in chronic low back pain (CLBP) patients. Methodology: Literature was searched using many electronic databases. Additionally, reference list of most prominent articles were searched to increase the search accuracy, as much as possible. Studies which are evaluating the concept of CS in conservatively treated CLBP patients were included. Results: Results of studies evaluating the responsiveness to various types of stimuli in CLBP patients are contradictory. Some studies in CLBP patients have showed increased pain responses after sensory stimulation of body parts outside the painful region, when some other studies report no differences between patients and healthy controls. Studies evaluating the integrity of the endogenous pain inhibitory systems describe unchanged activity of this descending inhibitory system. Conversely, studies examining brain structure and function in connection with experimentally induced pain provide initial proof for changed central pain processing in CLBP patients. Also inappropriate beliefs about pain, depression and/or pain catastrophizing, may lead to the development of CS. Conclusion: Most of the literatures suggest that the CNS becomes centrally sensitized in a subgroup of patients with CLBP. However, the significance of this involvement is just starting to become clearer. This could be an active topic of future research. More studies are necessary for providing definite evidence for the clinical importance of CS.