Longitudinal study of central sensitization and chronic low back pain in a Japanese cohort during the COVID-19 pandemic

This study utilized a longitudinal survey in Japan to investigate whether higher Central Sensitization Inventory (CSI) scores, serving as a proxy for central sensitization-related symptoms, are associated with an increased risk of developing chronic low back pain (CLBP), focusing on the impact of the coronavirus disease (COVID-19) pandemic on these conditions. Healthy volunteers (n = 227; mean age: 68.5 ± 9.5 years) were surveyed at baseline (July 2019) and at follow-up (October 2020). The participants were categorized into four groups based on their CLBP status: None, De novo, Continued, and Improved. CLBP prevalence increased from 26% at baseline to 32% at follow-up. Higher baseline CSI scores (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.02-1.09; p = 0.005) and older age (OR 1.06, 95% CI 1.02-1.11; p = 0.007) were identified as significant risk factors for developing CLBP. The mean CSI scores exhibited a slight non-significant increase from 16.9 ± 11.4 to 17.1 ± 11.7. Participants who adhered more strictly to the COVID-19 guidelines and engaged in reduced physical activity reported a higher CLBP prevalence. Our findings suggest that early identification and management of central sensitization are crucial for improving clinical outcomes, particularly during periods of external stress, such as the COVID-19 pandemic.