Central sensitization-related measures and peripheral treatment outcomes in patients with chronic pain: a systematic review and meta-analysis

Central sensitization-related measures and peripheral treatment outcomes in patients with chronic pain: a systematic review and meta-analysis. Download PDF Abstract Central sensitization may contribute to persistent pain and unfavorable outcomes following interventions targeting peripheral pain mechanisms. Clinical studies use heterogeneous approaches to assess central sensitization-related phenomena, most commonly the central sensitization inventory (CSI), alongside psychophysical measures of pain processing.

To systematically review the association between central sensitization-related self-report or psychophysical measures and clinical outcomes following invasive peripheral procedures in adults with chronic pain conditions, including low back pain, knee and hip osteoarthritis, endometriosis-related pain, shoulder pain, and abdominal nerve entrapment, and to quantitatively synthesize their association with post-intervention pain intensity. This systematic review and meta-analysis followed PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD42024592591). PubMed, Scopus, Web of Science, and ScienceDirect were searched between October 1 and November 10, 2025, for original studies published between 2015 and 2025.

Eligible studies included adults with chronic pain who underwent an invasive peripheral procedure and were assessed using a central sensitization-related self-report or psychophysical measure related to central pain processing; non-original reports and studies not meeting these eligibility criteria were excluded. Risk-of-bias was assessed using the quality in prognosis studies tool. Findings were synthesized narratively, and post-intervention pain intensity was quantitatively synthesized using a random-effects meta-analysis with Cohen’s d and 95% confidence intervals.

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