The Central Sensitization Inventory A User's Manual

  

Central Sensitization (CS) has been proposed as a common neurophysiological phenomenon to explain related syndromes for which no specific organic cause can be found.(1) The term Central Sensitivity Syndrome (CSS) is a newly proposed category for a group of inter-related disorders for which CS is a common etiology, including:(1,2)

The Central Sensitization Inventory A User's Manual Free

Jan 02, 2014  Aside from offering a top shelf review of true central sensitisation, L&W present to us a challenging reality – that central sensitisation causes allodynia and hyperalgesia in the problem area (primary allodynia and hyperalgesia) and the surrounding tissue (secondary.), but it does not cause reduced pain thresholds, temporal wind-up. The central sensitization inventory: A user’s manual Randy Neblett PRIDE Research Foundation, Dallas, TX, USA Correspondence Randy Neblett, PRIDE, Dallas, TX, USA. Email: randyneblett@pridedallas.com The Central Sensitization (CSI) Inventory was introduced in 2012. It was initially intended as a screener to help iden - tify when presenting. Sep 25, 2017  The Central Sensitization Inventory (CSI) September 25, 2017 Brett Jarosz Central Sensitization (CS) has been proposed as a common neurophysiological phenomenon to explain related syndromes for which no specific organic cause can be found.(1) The term Central Sensitivity Syndrome (CSS) is a newly proposed category for a group of inter-related. BACKGROUND: The Central Sensitization Inventory (CSI) and Pain Sensitivity Questionnaire (PSQ) are alternatives to quantitative sensory testing (QST) for inferring central sensitization. OBJECTIVE: Explore 1) comparative validity of the CSI and PSQ with QST (construct validity) and pain-related psychological questionnaires (concurrent validity), and 2) associations with widespread pain sensitivity. In 2012 Mayer et al. Proposed the Central Sensitization Inventory (CSI). The clinical goal of this screening instrument is to help better assess symptoms thought to be associated with CS in order to aid physicians and other clinicians in syndrome categorization, sensitivity, severity identification, and treatment planning, to help minimize, or possibly avoid, unnecessary diagnostics and treatment procedures. Purposing: The Central Sensitization Inventory (CSI) is a new patient‑reported instrument, which measures symp‑ toms related to Central Sensitivity Syndromes and Central Sensitization.

Central
  • Fibromyalgia
  • Myofascial Pain Syndrome
  • Chronic Fatigue Syndrome
  • Temporomandibular Joint Disorder
  • Irritable Bowel Syndrome
  • Migraine/Tension Type Headaches
  • Restless Leg Syndrome
  • Multiple Chemical Sensitivity

The Central Sensitization Inventory (CSI) was developed by Mayer et al (1) in 2012 to assess the overlapping health-related symptom dimensions of CS/CSSs. It was originally designed as a screening instrument to help identify when a patient’s presenting symptoms may indicate the presence of a CSS diagnosis, so that potentially unnecessary diagnostic and treatment procedures can be avoided, and biopsychosocial treatment planning can be initiated.

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The CSI has been found to have a high degree of test-retest reliability and internal consistency.(1) A 2017 systematic review looking at the measurement properties of the CSI concluded “…the tool generates reliable and valid data that quantifies the severity of several symptoms of CS.”(3)

A 2015 study found that patients with high CSI scores (>40) before knee replacement reported more severe postsurgical pain intensity, required higher dosage of postsurgical analgesics, and were at higher risk of persistent pain 3 months later.(5) Use of the CSI, with the 40-point cut-off score, has also been recommended to help classify chronic pain patients with CS, and to help differentiate them from patients with neuropathic and nocioceptive pain.(6,7)

Total scores on the CSI range from 0-100, with the following severity ranges recommended:

  • Subclinical = 0 to 29;
  • Mild = 30 to 39;
  • Moderate = 40 to 49;
  • Severe = 50 to 59;
  • Extreme = 60 to 100.

A 2017 study provided “support for these CSI severity levels as a guideline for healthcare providers and researchers in interpreting CSI scores and evaluating treatment responsiveness.”(4)

In summary, the CSI is appropriate for clinical purposes with higher CSI scores, indicating a higher probability of CS. Additionally, a CSI score of >40-points is clinically significant, providing both good sensitivity and specificity for the presence of CSS.

Easily administer, score and interpret outcome measures – including the CSI – through Erepsonline. For more information on selecting and viewing outcome measures, see the Erepsonline Video Tutorials, or check out the Quick Start Guide

References:

  1. Mayer TG, Neblett R, Cohen H, Howard KJ, Choi YH, Williams MJ, et al. The development and psychometric validation of the central sensitization inventory. Pain Pract. 2012 Apr;12(4):276–85.
  2. PRIDE; c2017 [cited 2017 September 13]. Available from: https://www.pridedallas.com/questionnaires/
  3. Scerbo T, Colasurdo J, Dunn S, Unger J, Nijs J, Cook C. Measurement Properties of the Central Sensitization Inventory: A Systematic Review. Pain Pract. 2017 Aug 29.
  4. Neblett R, Hartzell MM, Mayer TG, Cohen H, Gatchel RJ. Establishing Clinically Relevant Severity Levels for the Central Sensitization Inventory. Pain Pract. 3rd ed. 2017 Feb 1;17(2):166–75.
  5. Kim SH, Yoon KB, Yoon DM, Yoo JH, Ahn KR. Influence of centrally mediated symptoms on postoperative pain in osteoarthritis patients undergoing total knee arthro- plasty: a prospective observational evaluation. Pain Pract. 2015;15:E46–E53.
  6. Nijs J, Torres-Cueco R, van Wilgen CP, et al. Applying modern pain neuroscience in clinical practice: criteria for the classification of central sensitization pain. Pain Physician. 2014;17:447–457.
  7. Nijs J, Apeldoorn A, Hallegraeff H, et al. Low back pain: guidelines for the clinical classification of predominant neuropathic, nociceptive, or central sensitization pain. Pain Physician. 2015;18:E333–E346.

For the Central Sensitization Inventory, Click Here. In languages other than English, Click Here.

The Central Sensitization Inventory A User

I have around 100 of these symptoms, ranging from mild to severe and at various stages of exposure. This is how CSS becomes debilitating, not just from one severe symptom, but from MANY symptoms occurring at the same time, or in the same day, with multiple levels of severity.

The Central Sensitization Inventory A User's Manual 2016

For ease in printing, this form is available PDF format.

Please indicate on a scale of 1 to 10, with 10 being the most severe, the severity of each symptom you experience (using the past month as a general guide). If you do not have the symptom, leave the space blank.

GENERAL
____ Fatigue, made worse by physical exertion or stress
____ Activity level decreased to less than 50% of pre-illness activity level
____ Recurrent flu-like illness
____ Sore throat
____ Hoarseness
____ Tender or swollen lymph nodes (glands), especially in neck and underarms
____ Shortness of breath (air hunger) with little or no exertion
____ Frequent sighing
____ Tremor or trembling
____ Severe nasal allergies (new allergies or worsening of previous allergies)
____ Cough
____ Night sweats
____ Low-grade fevers
____ Feeling cold often
____ Feeling hot often
____ Cold extremities (hands and feet)
____ Low body temperature (below 97.6)
____ Low blood pressure (below 110/70)
____ Heart palpitations
____ Dryness of eyes and/or mouth
____ Increased thirst
____ Symptoms worsened by temperature changes
____ Symptoms worsened by air travel
____ Symptoms worsened by stress

PAIN
____ Headache – Killer Headaches
____ Tender points or trigger points
____ Muscle pain
____ Muscle twitching
____ Muscle weakness
____ Paralysis or severe weakness of an arm or leg
____ Joint pain
____ TMJ syndrome
____ Chest pain
____ Nerve pain

GENERAL NEUROLOGICAL
____ Lightheadedness; feeling “spaced out”
____ Inability to think clearly (“brain fog”)
____ Seizures
____ Seizure-like episodes
____ Syncope (fainting) or blackouts
____ Sensation that you might faint
____ Vertigo or dizziness
____ Numbness or tingling sensations
____ Tinnitus (ringing in one or both ears), Ringing in one ear
____ Photophobia (sensitivity to light)
____ Noise intolerance

EQUILIBRIUM/PERCEPTION
 ____ Feeling spatially disoriented
____ Dysequilibrium (balance difficulty)
____ Staggering gait (clumsy walking; bumping into things)
____ Dropping things frequently
____ Difficulty judging distances (e.g. when driving; placing objects on surfaces)
____ “Not quite seeing” what you are looking at

SLEEP
 ____ Hypersomnia (excessive sleeping)
____ Sleep disturbance: unrefreshing or non-restorative sleep
____ Sleep disturbance: difficulty falling asleep
____ Sleep disturbance: difficulty staying asleep (frequent awakenings)
____ Sleep disturbance: vivid or disturbing dreams or nightmares
____ Altered sleep/wake schedule (alertness/energy best late at night)

MOOD/EMOTIONS
 ____ Depressed mood
____ Suicidal thoughts
____ Suicide attempts
____ Feeling worthless
____ Frequent crying
____ Feeling helpless and/or hopeless
____ Inability to enjoy previously enjoyed activities
____ Increased appetite
____ Decreased appetite
____ Anxiety or fear when there is no obvious cause
____ Panic attacks
____ Irritability; overreaction
____ Rage attacks: anger outbursts with little or no cause
____ Abrupt, unpredictable mood swings
____ Phobias (irrational fears)
____ Personality changes

EYES AND VISION
 ____ Eye pain
____ Changes in visual acuity (frequent changes in ability to see well)
____ Difficulty with accommodation (switching focus from one thing to another)
____ Blind spots in vision

SENSITIVITIES
 ____ Sensitivities to medications (unable to tolerate “normal” dosage)
____ Sensitivities to odors – smells
____ Sensitivities to foods
____ Alcohol intolerance
____ Auditory sensitivity (sound)
____ Alteration of taste, smell, and/or hearing
____ Light Sensitivity In general – Drug induced
____ Electrical sensitivities

UROGENITAL
 ____ Frequent urination
____ Painful urination or bladder pain
____ Prostate pain
____ Impotence
____ Endometriosis
____ Worsening of premenstrual syndrome (PMS)
____ Decreased libido (sex drive)

GASTROINTESTINAL
 ____ Stomach ache; abdominal cramps
____ Nausea
____ Vomiting
____ Esophageal reflux (heartburn)
____ Frequent diarrhea
____ Chronic constipation
____ Bloating; intestinal gas
____ Decreased appetite
____ Increased appetite
____ Food cravings
____ Weight gain (____ lbs)
____ Weight loss (____ lbs)

SKIN

____ Rashes or sores
____ Eczema or psoriasis
____ Acne

OTHER
____ Hair loss
____ Mitral valve prolapse
____ Cancer
____ Dental problems
____ Periodontal (gum) disease
____ Aphthous ulcers (canker sores)

COGNITIVE
____ Difficulty with simple calculations (e.g., balancing checkbook)
____ Word-finding difficulty
____ Using the wrong word
____ Difficulty expressing ideas in words
____ Difficulty moving your mouth to speak
____ Slowed speech
____ Stuttering; stammering
____ Impaired ability to concentrate
____ Easily distracted during a task
____ Difficulty paying attention
____ Difficulty following a conversation when background noise is present
____ Losing your train of thought in the middle of a sentence
____ Difficulty putting tasks or things in proper sequence
____ Losing track in the middle of a task (remembering what to do next)
____ Difficulty with short-term memory
____ Difficulty with long-term memory
____ Forgetting how to do routine things
____ Difficulty understanding what you read
____ Switching left and right
____ Transposition (reversal) of numbers, words and/or letters when you speak
____ Transposition (reversal) of numbers, words and/or letters when you write
____ Difficulty remembering names of objects
____ Difficulty remembering names of people
____ Difficulty recognizing faces
____ Difficulty following simple written instructions
____ Difficulty following complicated written instructions
____ Difficulty following simple oral (spoken) instructions
____ Difficulty following complicated oral (spoken) instructions
____ Poor judgment
____ Difficulty making decisions
____ Difficulty integrating information (putting ideas together to form a complete picture or concept)
____ Difficulty following directions while driving
____ Becoming lost in familiar locations when driving
____ Feeling too disoriented to drive