The Central Sensitization Inventory and Pain Sensitivity Questionnaire: An exploration of construct validity and associations with widespread pain sensitivity among individuals with shoulder pain

Background: The Central Sensitization Inventory (CSI) and Pain Sensitivity Questionnaire (PSQ) are alternatives to quantitative sensory testing (QST) for inferring central sensitization. Objective: Explore 1) comparative validity of the CSI and PSQ with QST (construct validity) and pain-related psychological questionnaires (concurrent validity), and 2) associations with widespread pain sensitivity. Methods: Seventy-eight participants with unilateral shoulder pain less than 6 months (mean +/- SD age = 39.0 +/- 14.5 years, N (%) females = 36 (46.2%)) completed the CSI, PSQ, psychological questionnaires, and underwent QST for local and remote pressure pain thresholds (PPT), heat pain threshold, and suprathreshold heat pain ratings. Data from 25 age and sex-matched healthy participants (mean +/- SD age = 35.2 +/- 11.1 year, N (%) females = 13 (52.0%)) were used to determine a composite index for widespread pressure pain sensitivity in the shoulder pain group. Analyses included correlations between measures and between-group comparisons. Results: Only the PSQ was associated with remote PPT (rho range = -0.25 to - 0.27). Both the CSI and PSQ were associated with resilience (rho range = - 0.29 to - 0.39), anxiety (rho range = 0.25 to 0.66), and negative affect (rho range = 0.27 to 0.67). Neither the CSI nor PSQ were associated with widespread pain sensitivity (p > 0.05). Resilience (adjusted OR = 0.41, 95% CI = 0.18; 0.94) was a distinctive feature for widespread pain sensitivity. Conclusions: These preliminary findings challenge the exclusive use of the CSI or PSQ for inferring central sensitization among individuals with shoulder pain.