Assessment and manifestation of central sensitisation across different chronic pain conditions

Arendt‐Nielsen, L.; Morlion, B.; Perrot, S.; Dahan, A.; Dickenson, A.; Kress, H.G.; Wells, C.; Bouhassira, D.; Drewes, A. Mohr

doi:10.1002/ejp.1140

Cited by 696Pain Mechanisms and TreatmentsPain Management and TreatmentMusculoskeletal pain and rehabilitation

Assessment and manifestation of central sensitisation across different chronic pain conditions

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Arendt‐Nielsen, L., Morlion, B., Perrot, S., Dahan, A., Dickenson, A., Kress, H.G., Wells, C., Bouhassira, D. +1 more·2018·European Journal of Pain

DOI 10.1002/ejp.1140

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Abstract

Different neuroplastic processes can occur along the nociceptive pathways and may be important in the transition from acute to chronic pain and for diagnosis and development of optimal management strategies. The neuroplastic processes may result in gain (sensitisation) or loss (desensitisation) of function in relation to the incoming nociceptive signals. Such processes play important roles in chronic pain, and although the clinical manifestations differ across condition processes, they share some common mechanistic features. The fundamental understanding and quantitative assessment of particularly some of the central sensitisation mechanisms can be translated from preclinical studies into the clinic. The clinical perspectives are implementation of such novel information into diagnostics, mechanistic phenotyping, prevention, personalised treatment, and drug development. The aims of this paper are to introduce and discuss (1) some common fundamental central pain mechanisms, (2) how they may translate into the clinical signs and symptoms across different chronic pain conditions, (3) how to evaluate gain and loss of function using quantitative pain assessment tools, and (4) the implications for optimising prevention and management of pain. The chronic pain conditions selected for the paper are neuropathic pain in general, musculoskeletal pain (chronic low back pain and osteoarthritic pain in particular), and visceral pain (irritable bowel syndrome in particular). The translational mechanisms addressed are local and widespread sensitisation, central summation, and descending pain modulation. Significance: Central sensitisation is an important manifestation involved in many different chronic pain conditions. Central sensitisation can be different to assess and evaluate as the manifestations vary from pain condition to pain condition. Understanding central sensitisation may promote better profiling and diagnosis of pain patients and development of new regimes for mechanism based therapy. Some of the mechanisms underlying central sensitisation can be translated from animals to humans providing new options in development of therapies and profiling drugs under development.

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Studies indicate that the nervous system's sensitivity is linked to chronic pain.
“Chronic pain is multifactorial, but studies indicate that the nervous system’s sensitivity is linked to chronic pain [38, 60].”
From Changes in pain, daily occupations, lifestyle, and health following an occupational therapy lifestyle intervention: a secondary analysis from a feasibility study in patients with chronic high-impact pain (2024) · cites this paper as [60]
A recent paper has noticed differences in pain sensitization mechanisms in the body and brain across different persistent pain conditions such as IBS and musculoskeletal conditions such as persistent lower back pain.
“A recent paper has noticed differences in pain sensitization mechanisms in the body and brain across different persistent pain conditions such as IBS and musculoskeletal conditions such as persistent lower back pain.26”
From Psychological interventions for women with persistent pelvic pain: A survey of mental health clinicians (2021) · cites this paper as [26]

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Arendt-Nielsen, L., Graven-Nielsen, T., Petrini, L. (2012b). Experimental human model and assessenmt of pain in non-pain conditions. In Pain Comorbidities: Understandning and Treating the Complex Patient. Giamberardino, M.A., Jensen, T.S., eds. (Washington DC: IASP Press) 57-83.

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Authors: Arendt‐Nielsen, L., Morlion, B., Perrot, S., Dahan, A., Dickenson, A., Kress, H. G., Wells, C., Bouhassira, D., & Drewes, A. M.
Affiliations: Aalborg University (DK)
Universitair Ziekenhuis Leuven (BE)
Inserm (FR)
Leiden University Medical Center (NL)
University College London (GB)
Vienna General Hospital (AT)
Pain Matters Ltd Liverpool UK
Aalborg University Hospital (DK)
Corresponding author: Arendt‐Nielsen, L.
ORCID: Arendt‐Nielsen, L.
Morlion, B.
Perrot, S.
Dahan, A.
Dickenson, A.
Kress, H.G.
Bouhassira, D.
Drewes, A. Mohr
Venue: European Journal of Pain
Publisher: Wiley
Published: 2017-11-05
Volume: 22
Issue: 2
Pages: 216-241
ISSN: 1090-3801 (ISSN-L)
1532-2149
DOI: 10.1002/ejp.1140
OpenAlex: W2766251233
Cited by: 695
References: 345
Citations by year: 2026: 60 · 2025: 78 · 2024: 100 · 2023: 89 · 2022: 85 · 2021: 112 · 2020: 86 · 2019: 60 · 2018: 22 · 2017: 1
FWCI: 5.67
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: European Journal of Pain (publishedVersion)
PubMed (publishedVersion)
Lirias (submittedVersion)
VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
Topics: Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords: central sensitization, chronic pain, neuroplasticity, neuropathic pain, musculoskeletal pain, chronic low back pain, osteoarthritis, visceral pain, irritable bowel syndrome, descending pain modulation, quantitative pain assessment, pain mechanisms, pain phenotyping, pain prevention
MeSH terms: Animals, Humans, Neuralgia, Pain Measurement, Low Back Pain, Central Nervous System Sensitization, Chronic Pain, Musculoskeletal Pain

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Assessment and manifestation of central sensitisation across different chronic pain conditions

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