Central Sensitisation as a Clinical Label: What It Explains, What It Excuses and How Patients Hear It
DOI:
https://doi.org/10.5281/zenodo.22548493Keywords:
Central sensitisation, Nociplastic pain, Central Sensitization Inventory, Pain neuroscience education, Chronic pain classification, Patient communicationAbstract
rvous system processing of nociceptive input -- but the term has migrated from a mechanistic
explanation into a clinical label applied, often on symptom pattern alone, to patients whose pain does not
map cleanly onto tissue pathology. Validated instruments such as the Central Sensitization Inventory
correlate only weakly with direct sensitisation testing and overlap substantially with general
psychological distress, and consensus statements explicitly caution against using questionnaire scores as
a standalone diagnosis. How the label is communicated to patients also matters independently of its
accuracy: pain neuroscience education delivered well measurably reduces catastrophising and fear of
movement, while a label delivered as an explanation of last resort risks being heard as 'the pain is in your
head'. This review synthesises what the label reliably explains, where it is applied beyond its evidence
base, and what the communication literature says about delivering it well.
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