Central sensitization may worsen symptoms of musculoskeletal pain in individuals with inflammatory bowel disease (IBD), according to a study published in Pain Practice.
The study was conducted using a cross-sectional survey of adults in New Zealand with a previous diagnosis of IBD (ie, Crohn’s disease, ulcerative colitis, or indeterminate colitis; n=208). The survey assessed disease activity and several dimensions of musculoskeletal pain, including pain location, pain severity evaluated with a numeric rating scale, and pain interference assessed with the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference, as well as central sensitization, using a central sensitization inventory (CSI).
According to an unadjusted univariate linear regression analysis, IBD activity was found to be predictive of increased musculoskeletal pain severity (R2=0.039; P <.005) and increased musculoskeletal pain interference (R2=0.067; P <.001). IBD activity was also found to be a predictor of increased CSI scores (P <.001), and CSI scores were predictive of increased musculoskeletal pain severity (P <.001), in a mediation analysis.
After controlling for CSI scores, IBD activity was no longer a predictor of musculoskeletal pain severity. In a serial mediation analysis, IBD activity was found to be a predictor of increased CSI scores (P <.001) and CSI scores, independently (P <.001). IBD activity was no longer predictive of musculoskeletal pain interference after adjusting for CSI and MSK pain severity scores.
Study limitations include the small sample size, the use of a survey, the reliance on self-reported measures, and a high prevalence of women in the cohort (82.7%).
“Study results…implicate the possibility of central mechanisms in the development and/or maintenance of [musculoskeletal] pain states in this population,” concluded the study authors.
Falling CL, Stebbings S, Baxter GD, Gearry RB, Mani R. Central sensitization inventory mediates the relationship between inflammatory bowel disease activity and worse musculoskeletal pain experiences [published online July 18, 2019]. Pain Pract. doi:10.1111/papr.12821