Breaking the Pain Cycle: Amplifier Loops, Central Sensitization, and a CSI-Guided Clinical Decision Framework — A Scoping Review

Javier Arranz-Durán, Eswary Koovor, David Abejón-González, Tomás Domingo-Rufes, Enrique González, Carlos Horas-Barrera
2026 · doi:10.5281/zenodo.19323419 · W7143004269
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⚙ AI-generated summary by qwen3.7-flash, 2026-09-08 ⓘ

This scoping review maps amplifier loops sustaining central sensitization in chronic pain and proposes a clinical decision framework, including analysis of how preoperative central sensitization indices predict outcomes in endometriosis surgery.

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This scoping review maps the amplifier loops that sustain central sensitization in chronic pain and proposes a clinical decision framework guided by Central Sensitization Inventory scores. The authors analyzed 59 references to identify how preoperative central sensitization predicts outcomes across various surgical interventions, including knee and hip arthroplasty, spine surgery, and functional restoration programs. A key finding is the integration of diagnostic criteria with loop-targeted sequencing to improve core outcome domains for patients undergoing these procedures. Relevance to endometriosis: the paper lists endometriosis surgery as one of the specific intervention contexts where preoperative CSI scores were analyzed to predict patient outcomes.

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Abstract

This scoping review (PRISMA-ScR) maps the major amplifier loops sustaining central sensitization in chronic pain and proposes a CSI-guided clinical decision framework. The article includes 59 verified references, Table 1 (IASP Diagnostic Integration and Loop-Targeted Sequencing), Table 2 (Impact of Preoperative CSI on IMMPACT Core Outcome Domains Across Surgical and Interventional Procedures), and two figures (Clinical Decision Tree and PRISMA-ScR Flow Diagram). Version 3 adds Section 5.3 analyzing how preoperative CSI scores predict IMMPACT outcomes across knee/hip arthroplasty, spine surgery, endometriosis surgery, and functional restoration programs.
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Breaking the Pain Cycle: Amplifier Loops, Central Sensitization, and a CSI-Guided Clinical Decision Framework — A Scoping Review Authors/Creators - 1. Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain Description This scoping review (PRISMA-ScR) maps the major amplifier loops sustaining central sensitization in chronic pain and proposes a CSI-guided clinical decision framework. The article includes 59 verified references, Table 1 (IASP Diagnostic Integration and Loop-Targeted Sequencing), Table 2 (Impact of Preoperative CSI on IMMPACT Core Outcome Domains Across Surgical and Interventional Procedures), and two figures (Clinical Decision Tree and PRISMA-ScR Flow Diagram). Version 3 adds Section 5.3 analyzing how preoperative CSI scores predict IMMPACT outcomes across knee/hip arthroplasty, spine surgery, endometriosis surgery, and functional restoration programs. Files Files (56.9 kB) | Name | Size | Download all | |---|---|---| | md5:05c0ce9622aeb67b27f69cc09965dbcd | 56.9 kB | Download |

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