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Can Central Sensitization After Injury Persist as an Autonomous Pain Generator? A Comprehensive Search for Evidence
Graeme A Brazenor1, Gregory M Malham1, Peter J Teddy2
1Department of Neurosurgery, Epworth Hospital, Richmond, Victoria, Australia.
Pain Medicine (Malden, Mass.)
|October 31, 2021
Summary
This review found no evidence that central sensitization acts as a persistent pain generator after injury healing. The clinical diagnosis of central sensitization in humans lacks strong evidential support.
Area of Science:
- Pain research
- Neuroscience
- Clinical diagnostics
Background:
- Central sensitization is hypothesized to cause persistent pain after injuries heal.
- Understanding the role of central sensitization is crucial for effective pain management.
Purpose of the Study:
- To comprehensively search for evidence on central sensitization as a persistent pain generator post-injury.
- To evaluate the validity of diagnosing central sensitization in humans.
Main Methods:
- Systematic literature search of Medline on PubMed and Cochrane Library.
- Screening of 3,572 abstracts, followed by full-text review of 937 articles.
- Analysis of 751 relevant articles for evidence regarding central sensitization.
Main Results:
- No strong evidence supports central sensitization as an autonomous pain generator after injury healing.
- Significant weaknesses identified in the literature supporting central sensitization diagnosis in humans.
- Issues include extrapolation of animal data, failure to exclude peripheral generators, and confounding factors in testing.
Conclusions:
- Current evidence does not prove central sensitization persists autonomously post-injury.
- The evidential basis for diagnosing central sensitization in individual patients is questionable.
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