Central sensitization in chronic lumbar spine pain – pathophysiology and diagnostics

Chronic low back pain is a substantial clinical problem because of its high prevalence, incidence, complex and heterogeneous symptomatology. The majority of patients experience nociceptive pain only, but in almost 40% of patients neuropathic component may be present. In many patients with low back pain symptoms associated with central sensitization may be present as well and therefore their pain can be classified as nocyplastic. (functional) This paper describes how clinicians can differentiate these types of pain, taking into account that in a given patient several mechanisms may contribute to chronic pain development, and pain results from complex mechanisms. In the second part, therapeutic options are presented for people with symptoms of central sensitization, with emphasis on non-pharmacological methods.