The relationship of central sensitization with disability, pain catastrophizing, depression, and sleep quality in patients with lumbar spinal stenosis

J Orthop Sci. 2026 Mar 4:S0949-2658(26)00039-4. doi: 10.1016/j.jos.2026.02.013. Online ahead of print.

ABSTRACT

OBJECTIVE: Chronic pain in lumbar spinal stenosis (LSS) may play an important role in developing central sensitization (CS) symptoms. However, the relationship between CS severity and clinical parameters in LSS is unclear. This study aimed to compare pain intensity, pressure pain threshold (PPT), disability, pain catastrophizing, depression, and sleep quality across CS severity in LSS patients and to examine their relationships.

METHODS: This cross-sectional study included 81 patients with LSS. Patients were divided into two groups according to Central Sensitization Inventory (CSI) scores: high CSI and low CSI. Pain intensity (Numeric Rating Scale (NRS)), PPT, disability (Oswestry Disability Index (ODI)), pain catastrophizing (Pain Catastrophizing Scale (PCS)), depression (Center for Epidemiologic Studies Depression Scale (CES-D)), and sleep quality (Pittsburgh Sleep Quality Index (PSQI)) were assessed.

RESULTS: Patients with LSS with high CSI had statistically significantly higher NRS, ODI, PCS, CES-D, and PSQI scores (p < 0.05) and lower PPT (p = 0.010) values than those with low CSI. ODI (OR = 1.069) and PSQI (OR = 1.545) scores increase the risk of high CSI (p < 0.001). In addition, increases in ODI (B = 0.215), CES-D (B = 0.316), and PSQI (B = 1.563) scores and decreases in PPT (B = -2.033) are significant predictors of CSI score (p < 0.001).

CONCLUSIONS: LSS patients with high CSI have more pain, disability, pain catastrophizing, and depression, lower PPT, and worse sleep quality. Furthermore, decreased PPT, increased disability and depression, and worse sleep quality were associated with increased CSI score. Therefore, to effectively manage LSS, increased CS severity and its relationship to psychosocial factors that influence patients' pain experience should be assessed.

PMID:41786540 | DOI:10.1016/j.jos.2026.02.013