Here is a critical analysis that will put the ‘cat amongst pigeons.’
Whilst the authors do not deny a potential causal relationship between CS and chronic pain, they highlight that such a relationship has not been conclusively proven despite widespread acceptance in the field.
It is well worth reading, as it shakes the substratum of this perception and calls for a change in the ‘lens’.
In summary, the authors emphasise and assert:
- The causal relationship between CS and chronic pain has not been conclusively demonstrated, contrary to common belief.
- CS is primarily a correlative finding observed in animal pain models, but its direct presence in humans lacks definitive proof.
- While animal studies show that pain models can produce CS, there is no conclusive evidence that CS itself causes chronic pain.
- The lack of a clear biological explanation for chronic pain has led to CS being used as an expedient pathophysiology to explain poorly understood pain conditions.
- This conviction of CS as an explanation has created confusion about its nature and measurement.
- Assuming CS as the underlying pathophysiological process causing chronic pain may hinder further research into alternative explanations or mechanisms.
Reference:
E Velasco et al, Is chronic pain caused by central sensitization? A review and critical point of view. Neurosci Biobehav Rev. 2024 Sep 13:167:105886. doi: 10.1016/j.neubiorev.2024.105886.
