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Central sensitization
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== Criteria for the classification of central sensitization pain == [[File:Algorithm-for-the-classification-of-central-sensitization-CS-pain.png|thumb|488x488px|Algorithm for the classification of central sensitization CS (Nijs et al. 2014). ]]In 2014 a consensus paper was published by 18 experts from 7 different countries that set out criteria for the classification of central sensitization pain.<ref>{{Cite journal | last = Nijs | first = Jo | last2 = Torres-Cueco | first2 = Rafael | last3 = van Wilgen | first3 = C. Paul | last4 = Girbes | first4 = Enrique Lluh | last5 = Struyf | first5 = Filip | last6 = Roussel | first6 = Nathalie | last7 = van Oosterwijck | first7 = Jessica | last8 = Daenen | first8 = Liesbeth | last9 = Kuppens | first9 = Kevin | date = Sep 2014 | title = Applying modern pain neuroscience in clinical practice: criteria for the classification of central sensitization pain | url =https://www.ncbi.nlm.nih.gov/pubmed/25247901 | journal = Pain Physician | volume = 17 | issue = 5 | pages = 447–457|issn=2150-1149|pmid=25247901|quote= | authorlink = Jo Nijs|via= | author-link8 = Jessica Van Oosterwijck}}</ref> After neuropathic pain has been ruled out, the criteria advise to assess if the severity of pain is “disproportionate to the nature and extent of injury and pathology”. This is an obligatory criterion; if pain is not disproportionate, then it doesn’t involve CS. Secondly it is proposed to look at the pain distribution; if pain is widespread and diffuse then the clinician can diagnose CS in his patient. If this is not the case, then the clinician can use the Central Sensitization Inventory (CSI), a questionnaire that has been developed to assess CS and mostly looks at secondary symptoms like sensitivity to light, poor sleep and concentration problems. If the patient scores 40 or more on the CSI, then the diagnosis of CS should be made. Remarkably, psychological aspects such as [[Pain catastrophizing|catastrophizing]], somatization and hypervigilance – considered by some to be central to CS – are not included in the criteria. While the authors acknowledge the importance of these maladaptive psychosocial factors, they do not consider them to be unique to central sensitization as they are often present in other [[chronic pain]] patients as well.
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