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.
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
84
Türkoğlu Dr. Kemal Beyazıt State Hospital
Kahramanmaraş, Turkey (Türkiye)
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.
Time frame: 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.
Time frame: At baseline
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.
Time frame: 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
Time frame: At baseline (single time-point assessment)
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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 1. = Less than once a week 2. = Once or twice a week 3. = 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.
Time frame: 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.
Time frame: 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.
Time frame: At baseline