Evidence for central sensitization as classified by the central sensitization inventory in patients with pain and hypermobility

Pain Pract. 2025 Jan;25(1):e13411. doi: 10.1111/papr.13411. Epub 2024 Aug 27.

Abstract

Introduction: Pain is a very common complaint among patients with hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSDs). Often challenging to treat, insights into the underpinnings of pain in this population have been fleeting. Central sensitization (CS) has been postulated as a potential etiological factor.

Methods: In this retrospective study, 82 consecutive patients with hEDS/HSDs were reviewed. Demographic information and Central Sensitization Inventory (CSI) results were collected.

Results: 71 of 82 (86.5%) patients demonstrated CS. Scores ranged from 12 to 94 with a median of 56. Pain scores as measured on the numerical rating scale (NRS) ranged from 2 to 10 with a mean and median of 6.

Conclusion: A large percentage of patients with pain and a diagnosis of hEDS/HSDs demonstrated evidence of central sensitization as measured using the CSI. The CSI is simple to administer. The CSI may provide clinical insights that are key to successfully managing patients with hEDS/HSDs. Further research is needed to explore the ability to classify pain phenotypes in this patient population and the impact on precision medicine.

Keywords: hypermobility; pain; pain assessment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Central Nervous System Sensitization* / physiology
  • Ehlers-Danlos Syndrome / complications
  • Ehlers-Danlos Syndrome / diagnosis
  • Ehlers-Danlos Syndrome / physiopathology
  • Female
  • Humans
  • Joint Instability* / diagnosis
  • Joint Instability* / physiopathology
  • Male
  • Middle Aged
  • Pain Measurement* / methods
  • Pain* / diagnosis
  • Pain* / etiology
  • Pain* / physiopathology
  • Retrospective Studies
  • Young Adult