title: Central sensitization in chronic low back pain: A narrative review.
abstract: Low back pain is one of the four most common disorders in all regions, and the greatest contributor to disability worldwide, adding 10.7% of total years lost due to this health state. The etiology of chronic low back pain is, in most of the cases (up to 85%), unknown or nonspecific, while the specific causes (specific spinal pathology and neuropathic/radicular disorders) are uncommon. Central sensitization has been recently recognized as a potential pathophysiological mechanism underlying a group of chronic pain conditions, and may be a contributory factor for a sub-group of patients with chronic low back pain. The purposes of this narrative review are twofold. First, to describe central sensitization and its symptoms and signs in patients with chronic pain disorders in order to allow its recognition in patients with nonspecific low back pain. Second, to provide general treatment principles of chronic low back pain with particular emphasis on pharmacotherapy targeting central sensitization.
authors.affiliation: Section of Orthopedics and Traumatology, University of Messina, Messina, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Sanzarello
authors.affiliation: Laboratory of Musculoskeletal Cell Biology, Istituto Ortopedico Rizzoli, IRCCS, Bologna, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Merlini
authors.affiliation: Section of Orthopedics and Traumatology, University of Messina, Messina, Italy.
authors.forename: Michele Attilio
authors.initials: MA
authors.lastname: Rosa
authors.affiliation: Anesthesia and Post-Operative Intensive Care, Rizzoli-Sicilia Department, Rizzoli Orthopedic Institute, Bagheria (Palermo), Italy.
authors.forename: Mariada
authors.initials: M
authors.lastname: Perrone
authors.affiliation: Anesthesia and Post-Operative Intensive Care, Rizzoli-Sicilia Department, Rizzoli Orthopedic Institute, Bagheria (Palermo), Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Frugiuele
authors.affiliation: General Orthopedic Surgery, Rizzoli-Sicilia Department, Rizzoli Orthopedic Institute, Bagheria (Palermo), Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Borghi
authors.affiliation: General Orthopedic Surgery, Rizzoli-Sicilia Department, Rizzoli Orthopedic Institute, Bagheria (Palermo), Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Faldini
mesh_terms: D059333:Central Nervous System Sensitization / Q000502:physiology*; D059350:Chronic Pain / Q000175:diagnosis / Q000503:physiopathology*; D003937:Diagnosis, Differential; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology*
keywords: Chronic low back pain; central sensitization; chronic disorders