Central sensitization is a significant risk factor for the chronic low back pain — The International Society for the Study of the Lumbar Spine
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Central sensitization is a significant risk factor for the chronic low back pain (#ZO7)

Hiroshi Hashizume 1 2 , Hiroyuki Oka 3 , Shingo Inoue 1 , Seiji Kanno 1 , Yuki Matsuyama 1 , Takeru Ueno 1 , Akimasa Murata 1 , Yuusuke Kido 1 , Mayumi Sonekatsu 1 , Hidenobu Tamai 1 , Takashi Shimoe 1 , Ryo Taiji 1 , Shizumasa Murata 1 , Takuhei Kozaki 1 , Masatoshi Teraguchi 4 , YOSHIO ENYO 4 , Yukihiro Nakagawa 4 , Nobuyuki Miyai 2 , Hiroshi Yamada 1
  1. Dept. of Orthopaedic Surgery, Wakayama Medical University, Wakayama City, Wakayama, Japan
  2. School of Health and Nursing Science, Wakayama Medical University, Wakayama, Japan
  3. 22nd Century Medical and Research Center, The University of Tokyo Hospital, Tokyo, Japan
  4. Spine Care Center, Wakayama Medical University Kihoku Hospital, Katsuragi, Wakayama, Japan

Purpose: To clarify the relationship between central sensitization and chronic low back pain (CLBP), we conducted a longitudinal survey under the spread of COVID-19 infection in Japan.

Methods: Invitations were sent to 771 people who participated in the baseline survey in July 2019 before the spread of the COVID-19 infection in rural areas in Wakayama prefecture, and 227 people (79 men, 148 women, average age at baseline 68.5 ± 9.5 years) who participated in the follow-up survey in October 2020 were included in the analysis. The main evaluation items were (1) presence or absence of CLBP (definition: low back pain that lasts for 3 months or more), (2) central sensitization screening tool: Central Sensitization Inventory (CSI). At the time of follow-up survey, we also asked about whether or not to refrain from going out due to the spread of COVID-19 infection.

Statistics: First, we observed changes in the prevalence of CLBP and CSI scores through the observation period. Second, the participants were divided into the following four groups and the baseline characteristics were compared among the groups; (1) "None group" did not have CLBP through the observation period, (2) "De novo group" did not have CLBP at baseline while it had CLBP at follow-up, (3) "Continued group" had CLBP through the observation period, (4) "Improved group" had CLBP at the baseline while it did not have CLBP at the follow-up. Third, a multiple logistic regression analysis was conducted to elucidate risk factors for the development of CLBP on 167 patients who did not have CLBP at baseline.

Results: The prevalence of CLBP were 59/227 (26%) at baseline and 71/227 (32%) at follow-up. The CSI score was 16.9 at baseline and 17.1 at follow-up. There were 131 participants (60%) in the None group, 32 (15%) in the De novo group, 39 (18%) in the Continued group, and 15 (7%) in the Improved group. There were no significant differences in gender, age, BMI at baseline, and whether or not to refrain from going out among the four groups. The baseline CSI score (mean) was 14.2 in the None group, 17.9 points in the De novo group, 22 points in the Continued group, and 20 points in the Continued group- a significant difference was observed between the None group and the Continued group. The multiple logistic regression analysis revealed that higher baseline CSI scores were a significant risk factor for the development of CLBP.

Conclusion: (1) After the spread of COVID-19 infection, the prevalence of CLBP increased. (2) Higher CSI score was a significant risk factor for the development of CLBP.

#ISSLS2022