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=== Criteria for the classification of central sensitization pain === Jo Nijs is regarded as an international expert in central sensitization. He has researched CS in patients with chronic spinal pain, chronic low back pain,<ref>Nijs J, Apeldoorn A, Hallegraeff H, Clark J, Smeets R, Malfliet A, et al. Low back pain: guidelines for the clinical classification of predominant neuropathic, nociceptive, or central sensitization pain. Pain Physician. 2015 May-Jun;18(3):E333-46.</ref> shoulder pain,<ref>Sanchis MN, Lluch E, Nijs J, Struyf F, Kangasperko M. The role of central sensitization in shoulder pain: A systematic literature review. Semin Arthritis Rheum. 2015 Jun;44(6):710-6.</ref> knee osteoarthritis,<ref name="Lluch2017">Lluch E, Nijs J, Courtney CA, Rebbeck T, Wylde V, Baert I, et al. Clinical descriptors for the recognition of central sensitization pain in patients with knee osteoarthritis. Disabil Rehabil. 2017 Aug 2:1-10.</ref> cancer-related pain<ref name="Cancer2016">Nijs J, Leysen L, Adriaenssens N, Aguilar Ferrándiz ME, Devoogdt N, et al. Pain following cancer treatment: Guidelines for the clinical classification of predominant neuropathic, nociceptive and central sensitization pain. Acta Oncol. 2016 Jun;55(6):659-63.</ref> and chronic whiplash.<ref name="Oosterwijck2013">Van Oosterwijck J, Nijs J, Meeus M, Paul L. Evidence for central sensitization in chronic whiplash: a systematic literature review. Eur J Pain. 2013 Mar;17(3):299-312.</ref> In 2014, he was first author of a consensus paper in which 18 experts set out criteria for the diagnosis of central sensitivity.<ref name="Neuroscience2014">Nijs J, Torres-Cueco R, van Wilgen CP, Girbes EL, Struyf F, Roussel N, et al. Applying modern pain neuroscience in clinical practice: criteria for the classification of central sensitization pain. Pain Physician. 2014 Sep-Oct;17(5):447-57.</ref> After neuropathic pain has been ruled out, the criteria propose to assess if the severity of pain is “disproportionate to the nature and extent of injury and pathology”. This is an obligatory criterion; if pain is not disproportionate, then it doesn’t involve CS. Secondly it is proposed to look at the pain distribution; if pain is widespread and diffuse then the clinician can diagnose CS in his patient. If this is not the case, then the clinician can use the central sensitization inventory (CSI), a questionnaire that has been developed to assess CS and mostly looks at secondary symptoms like sensitivity to light, bad sleep and concentration problems. If the patient scores 40 or more on the CSI, than the clinician can make the diagnosis of CS.
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