Central Sensitization and Clinical Parameters in Chronic Neck Pain

Correlation of Central Sensitization With Pain, Pain Catastrophizing, Disability, Sleep Quality, and Jaw Function in Patients With Chronic Neck Pain: A Retrospective, Cross-Sectional Study

This study is a retrospective, cross-sectional observational study that assesses the correlations among central sensitization, pain, psychosocial factors, and temporomandibular function in patients with chronic neck pain. It underscores the importance of the biopsychosocial model in clinical practice and aims to improve understanding of central mechanisms in treatment planning. treatment planning.

Study Overview

• Status: Completed
• Conditions: Chronic Pain; Neck Pain; Temporomandibular Joint Dysfunction Syndrome; Central Nervous System Sensitization

Detailed Description

Chronic neck pain is a widespread health issue globally that negatively impacts quality of life. In some patients, pain cannot be explained solely by tissue damage; increased sensitivity of the central nervous system (central sensitization) may contribute to the persistence of pain.

The aim of this study is to explore the relationship between the level of central sensitization and the following parameters in individuals with chronic neck pain:

• Pain intensity
• Pressure pain threshold
• Pain catastrophizing level
• Neck-related disability
• Sleep quality
• Jaw function

The study has a retrospective, cross-sectional design. Records of patients previously evaluated in the clinic will be analyzed. No new interventions will be conducted on participants. The study is observational in nature.

This research aims to:

• Enhance understanding of the clinical significance of central sensitization in chronic neck pain
• Contribute to the development of multidisciplinary treatment strategies
• Support the management of patients through more personalized treatment plans.

• Study Type: Observational
• Enrollment (Actual): 84

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kahramanmaraş, Turkey (Türkiye), 46000
    • Türkoğlu Dr. Kemal Beyazıt State Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population includes patients living in Kahramanmaraş who have chronic neck pain. The sample consists of these patients who visited our clinic with this issue, received a diagnosis of chronic neck pain from a specialist, and agreed to take part in the study.

Description

Inclusion Criteria:

- Patients aged 18-60 years

Patients with neck pain lasting at least 3 months.

Patients with a pain intensity of 4 or higher on the Visual Analog Scale (VAS).

Patients with a Pain Catastrophizing Scale (PCS) score greater than 30.

Patients with a Central Sensitization Inventory (CSI) score greater than 30.

Patients who have not received physiotherapy or manual therapy in the past 3 months.

Exclusion Criteria:

- Individuals with a history of neck or spinal surgery.

Patients with a history of whiplash injury or fracture.

Individuals with unstable neurological findings.

Presence of cervical pathology such as herniation or nerve root compression.

Regular use of analgesic or anti-inflammatory medications.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Central Sensitization Inventory (CSI)	Central sensitization was assessed using the CSI, a tool applicable in cases of chronic pain. The CSI has two parts. Part A evaluates symptoms and is scored from 0 to 100; higher scores reflect greater central sensitization. A score of 30 or higher suggests the presence of central sensitization. Part B asks if the individual has ever been diagnosed with any central sensitization syndromes.	At baseline (single time-point assessment)
Visual Analog Scale (VAS)	Pain intensity will be assessed using the Visual Analog Scale (VAS). The VAS is commonly employed in clinical practice because it is simple to use and consistent. The scale ranges from 0 to 10, where "0" indicates no pain and "10" signifies the worst possible pain. Patients are informed that pain severity increases from 0 to 10 and are asked to mark the number that best reflects their pain level.	At baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Catastrophizing Scale (PCS)	Pain catastrophizing was measured with the PCS. This 13-item self-report questionnaire includes three subscales: rumination, magnification, and helplessness. Higher scores indicate more pain and greater functional impairment, with a total score above 30 signifying a clinically significant level of pain catastrophizing.	At baseline (single time-point assessment)
Neck Disability Index	Participants' neck disability levels were evaluated using the Neck Disability Index (NDI). The scale includes 10 items that address neck pain intensity, personal care, lifting, reading, headaches, concentration, driving, sleep, and recreational activities. Each item is scored from 0 to 5. The total score ranges from 0 to 50, with higher scores indicating greater disability. Disability levels are classified as follows: 0-4: No disability 5-14: Mild disability 15-24: Moderate disability 25-34: Severe disability 35 and above: Complete disability	At baseline (single time-point assessment)
Pittsburgh Sleep Quality Index (PSQI)	Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). The PSQI was created by Buysse et al. in 1989. The scale's validity and reliability in Turkish were tested by Agargün et al. in 1996. The questionnaire features 24 items related to both nighttime and daytime sleep. Nineteen items are self-rated, while five are answered by a bed partner or roommate. The five partner-rated items and the question asking whether the person has a sleep partner or roommate are not included in the scoring. Responses are rated on a 0-3 scale: 0 = Not during the past month; = Less than once a week; = Once or twice a week; = Three or more times a week Eighteen of the 24 items are scored, resulting in a total score from 0 to 21. A score of 5 or below indicates good sleep quality, while a score above 5 suggests poor sleep quality.	At baseline (single time-point assessment)
Jaw Functional Limitation Scale-20 (JFLS-20)	The Jaw Functional Limitation Scale-20 (JFLS-20) will be used to assess the level of temporomandibular joint function in individuals. The JFLS-20 is a questionnaire designed to measure disability in people with temporomandibular disorders. Each item is scored on a scale from 0 to 10, where 0 indicates no limitation and 10 indicates severe limitation. The total score ranges from 0 to 200, with higher scores indicating greater impairment. The JFLS-20 is a valid and reliable tool for clinical use.	At baseline
Assessment of Pressure Pain Threshold	Pressure pain sensitivity will be assessed using a digital pressure pain threshold (PPT) algometer (Wagner Instruments, Greenwich, USA). Measurements will be taken bilaterally from the upper trapezius, sternocleidomastoid, masseter, and temporalis muscles.	At baseline

Collaborators and Investigators

• Sponsor: Turkoglu Dr. Kemal Beyazit State Hospital
• Investigators: Study Director: Aysenur TUNCER, PT,PhD, Independent researcher

Publications and helpful links

General Publications

• No publications yet

Helpful Links

• The hospital where the study was conducted

Study record dates

Study Major Dates

• Study Start (Actual): April 5, 2024
• Primary Completion (Actual): December 17, 2024
• Study Completion (Actual): January 18, 2025

Study Registration Dates

• First Submitted: March 4, 2026
• First Submitted That Met QC Criteria: March 4, 2026
• First Posted (Actual): March 10, 2026

Study Record Updates

• Last Update Posted (Actual): March 10, 2026
• Last Update Submitted That Met QC Criteria: March 4, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Neck Pain; Disability; Catastrophization; Central Sensitization
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Stomatognathic Diseases; Muscular Diseases; Joint Diseases; Jaw Diseases; Mandibular Diseases; Craniomandibular Disorders; Myofascial Pain Syndromes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Temporomandibular Joint Disorders; Chronic Pain; Temporomandibular Joint Dysfunction Syndrome; Neck Pain
• Other Study ID Numbers: TurkogluBeyazitSH

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

De-identified individual participant data from this study will be available to qualified researchers upon reasonable request. The shared data will include anonymized clinical and questionnaire results used in this study.

Requests can be directed to the corresponding author, Dr. Süreyya Damar-Örenler (email: fztsureyya88@otmail.com). Data sharing will adhere to applicable ethical and privacy regulations.

IPD Sharing Time Frame

Start Date: 2026-06-01

End Date: 2031-06-01

• IPD Sharing Access Criteria: Data will be shared with researchers who submit a reasonable request describing the planned analyses and agree to use the data for research purposes only. A data use agreement may be required.
• IPD Sharing Supporting Information Type: SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No