Central Sensitization Inventory (CSI)

Objective

The Central Sensitization Inventory (CSI) is a self-report measurement tool that has been widely used to study and better assess symptoms of central sensitization in patients with chronic pain.¹ ² ³ ⁴

Interpretation

Higher scores indicate a greater degree of symptoms related to central sensitization.¹ A cutoff score of 40 has been reported as indicative of central sensitization.¹ ⁴

Severity levels have been proposed for clinical interpretation:

• subclinical = 0–29;
• mild = 30–39;
• moderate = 40–49;
• severe = 50–59;
• extreme = 60–100.¹ ⁵

Execution

The CSI is a two-part questionnaire:

• Part A measures a comprehensive range of 25 somatic and emotional symptoms associated with central sensitization, rated on a 5-point Likert scale ranging from 0 (never) to 4 (always), resulting in a possible total score of 100.¹
• Part B records previous diagnoses related to central sensitization or related disorders, including anxiety and depression. It is often excluded from clinimetric studies, and clinicians are advised to use only part A.¹ ²

Duration

Approximately 3 minutes to complete part A.¹

Equipment

None.

Clinical Value

The CSI has been shown to be useful and valid, with satisfactory psychometric properties in terms of test-retest reliability (ICC = 0.88–0.97) and Cronbach’s alpha (0.88–0.91).¹ ² ³

1- Nijs, Jo, and Eva Huysmans. “Clinimetrics: The Central Sensitisation Inventory: A Useful Screening Tool for Clinicians, but Not the Gold Standard.” Journal of Physiotherapy 68, no. 3 (July 2022): 207.

2- Mayer, Tom G., Randy Neblett, Howard Cohen, Krista J. Howard, Yun Hee Choi, Mark J. Williams, Yoheli Perez, and Robert J. Gatchel. “The Development and Psychometric Validation of the Central Sensitization Inventory (CSI).” Pain Practice 12, no. 4 (April 2012): 276–85.

3- Cuesta-Vargas, Antonio I., Randy Neblett, Alessandro Chiarotto, Jeroen Kregel, Jo Nijs, C. Paul van Wilgen, Laurent Pitance, et al. “Dimensionality and Reliability of the Central Sensitization Inventory in a Pooled Multicountry Sample.” The Journal of Pain 19, no. 3 (March 2018): 317–29.

4- Neblett, Randy, Howard Cohen, Yunhee Choi, Meredith Hartzell, Mark Williams, Tom G. Mayer, and Robert J. Gatchel. “THE CENTRAL SENSITIZATION INVENTORY (CSI): ESTABLISHING CLINICALLY-SIGNIFICANT VALUES FOR IDENTIFYING CENTRAL SENSITIVITY SYNDROMES IN AN OUTPATIENT CHRONIC PAIN SAMPLE.” The Journal of Pain: Official Journal of the American Pain Society 14, no. 5 (May 2013): 438–45.

5- Neblett, Randy, Meredith M. Hartzell, Tom G. Mayer, Howard Cohen, and Robert J. Gatchel. “Establishing Clinically Relevant Severity Levels for the Central Sensitization Inventory.” Pain Practice: The Official Journal of World Institute of Pain 17, no. 2 (February 2017): 166–75.