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Purpose <p>Central sensitization (CS)-related symptoms are associated with pain severity and disability in patients with knee osteoarthritis (KOA). However, the associations between CS-related symptoms and pressure pain threshold (PPT) measurements at local and remote sites remain unclear. This study investigated the associations between CS-related symptoms and PPTs at local and remote sites in patients with KOA.</p> Methods <p>This cross-sectional study included patients with KOA scheduled for primary unilateral total knee arthroplasty. CS-related symptoms were assessed using the Central Sensitization Inventory (CSI), and PPTs were measured at local (knee) and remote (forearm) sites. Multiple linear regression analyses were performed with CSI score as the independent variable and local and remote PPTs as dependent variables, adjusting for potential confounders. Regression coefficients and 95% confidence intervals (CIs) were estimated by bootstrap resampling with 10,000 iterations.</p> Results <p>A total of 121 patients were included in the final analysis. Higher CSI scores were not associated with local PPTs (B = − 0.284, 95% CI: − 0.616 to 0.047, <i>P</i> = 0.080). In contrast, higher CSI scores were associated with lower remote PPTs (B = − 0.287, 95% CI: − 0.499 to − 0.070, <i>P</i> = 0.015).</p> Conclusions <p>Greater CS-related symptom severity was associated with lower remote PPTs but not local PPTs in patients with KOA. These findings suggest that CS-related symptoms may reflect widespread pain hypersensitivity rather than localized pain sensitivity in patients with KOA.</p>

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Association between central sensitization-related symptoms and pressure pain thresholds at local and remote sites in patients with knee osteoarthritis

  • 期刊论文

  • 发表日期：

    2026年7月17日

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  • Junji Nishimoto,
  • Rina Nakagawa,
  • Rikumi Kurahashi,
  • Ryo Tanaka

摘要

Purpose

Central sensitization (CS)-related symptoms are associated with pain severity and disability in patients with knee osteoarthritis (KOA). However, the associations between CS-related symptoms and pressure pain threshold (PPT) measurements at local and remote sites remain unclear. This study investigated the associations between CS-related symptoms and PPTs at local and remote sites in patients with KOA.

Methods

This cross-sectional study included patients with KOA scheduled for primary unilateral total knee arthroplasty. CS-related symptoms were assessed using the Central Sensitization Inventory (CSI), and PPTs were measured at local (knee) and remote (forearm) sites. Multiple linear regression analyses were performed with CSI score as the independent variable and local and remote PPTs as dependent variables, adjusting for potential confounders. Regression coefficients and 95% confidence intervals (CIs) were estimated by bootstrap resampling with 10,000 iterations.

Results

A total of 121 patients were included in the final analysis. Higher CSI scores were not associated with local PPTs (B = − 0.284, 95% CI: − 0.616 to 0.047, P = 0.080). In contrast, higher CSI scores were associated with lower remote PPTs (B = − 0.287, 95% CI: − 0.499 to − 0.070, P = 0.015).

Conclusions

Greater CS-related symptom severity was associated with lower remote PPTs but not local PPTs in patients with KOA. These findings suggest that CS-related symptoms may reflect widespread pain hypersensitivity rather than localized pain sensitivity in patients with KOA.