This document provides a literature review on work-disabling low back pain and its relationship to central sensitivity syndromes. It summarizes 21 peer-reviewed studies that examine risk factors for developing chronic widespread pain from localized back pain, central sensitization in chronic low back pain patients, and the potential for low back pain to be classified as a central sensitivity disorder. The studies suggest that psychosocial factors can increase the risk of chronic disability from low back pain and that some patients may develop increased sensitivity in the central nervous system, contributing to chronic pain.

1. Work-Disabling LBP as a Central Sensitivity Spectrum Disorder
1. Spine (Phila Pa 1976). 1995 Dec 15;20(24):2702-9.The dominant role of
psychosocial risk factors in the development of chronic low back pain disability.
Gatchel RJ1, Polatin PB, Mayer TG.
2. Spine J. 2001 May-Jun;1(3):198-204. Psychological and functional profiles in
selected subjects with low back pain. Carragee EJ1.
3. Spine (Phila Pa 1976). 2004 May 15;29(10):1112-7. Prospective controlled study of
the development of lower back pain in previously asymptomatic subjects undergoing
experimental discography. Carragee EJ1, Barcohana B, Alamin T, van den Haak E.
4. Spine J. 2005 Jan-Feb;5(1):24-35.Discographic, MRI and psychosocial determinants
of low back pain disability and remission: a prospective study in subjects with benign
persistent back pain. Carragee EJ1, Alamin TF, Miller JL, Carragee JM.
5. Spine (Phila Pa 1976). 2006 Aug 15;31(18):2115-23. A gold standard evaluation of
the "discogenic pain" diagnosis as determined by provocative discography.
Carragee EJ1, Lincoln T, Parmar VS, Alamin T.
6. BMC Musculoskelet Disord. 2007; 8: 27. Published online 2007 Mar 9. doi:
10.1186/1471-2474-8-27 An internet survey of 2,596 people with fibromyalgia
Robert M Bennett,1 Jessie Jones,2 Dennis C Turk,3 I Jon Russell,4 and Lynne
Matallana
7. Semin Arthritis Rheum. 2008 Jun;37(6):339-52. doi: 10.1016/j.semarthrit.
2007.09.003. Epub 2008 Jan 14. Central sensitivity syndromes: a new paradigm and
group nosology for fibromyalgia and overlapping conditions, and the related issue of
disease versus illness.Yunus MB1.
8. Curr Rheumatol Rep. 2011 Dec;13(6):513-20. doi: 10.1007/s11926-011-0206-6.
Evidence for shared pain mechanisms in osteoarthritis, low back pain, and fibromyalgia.
Staud R1.
9. J Pain. 2010 Dec;11(12):1320-8. doi: 10.1016/j.jpain.2010.03.007. Epub 2010 May
21. Risk factors predicting the development of widespread pain from chronic back or
neck pain. Kindler LL1, Jones KD, Perrin N, Bennett RM.

2. 10. BMC Musculoskelet Disord. 2012 May 25;13:77. doi: 10.1186/1471-2474-13-77.
Study protocol: Transition from localized low back pain to chronic widespread pain in
general practice: identification of risk factors, preventive factors and key elements for
treatment--a cohort study. Viniol A1, Jegan N, Leonhardt C, Strauch K, Brugger M, Barth
J, Baum E, Becker A.
11. Brain. 2013 Sep;136(Pt 9):2751-68. doi: 10.1093/brain/awt211. Shape shifting pain:
chronification of back pain shifts brain representation from nociceptive to emotional
circuits. Hashmi JA1, Baliki MN, Huang L, Baria AT, Torbey S, Hermann KM, Schnitzer
TJ, Apkarian AV.
12. Arthritis Rheum. 2013 Dec;65(12):3285-92. doi: 10.1002/art.38178. Prevalence of
the fibromyalgia phenotype in patients with spine pain presenting to a tertiary care pain
clinic and the potential treatment implications.Brummett CM1, Goesling J, Tsodikov A,
Meraj TS, Wasserman RA, Clauw DJ, Hassett AL.
13. Ind Health. 2015;53(4):368-77. doi: 10.2486/indhealth.2014-0260. Epub 2015 Jun 6.
Assessment of psychosocial risk factors for the development of non-specific chronic
disabling low back pain in Japanese workers-findings from the Japan Epidemiological
Research of Occupation-related Back Pain (JOB) study. Matsudaira K1, Kawaguchi M,
Isomura T, Inuzuka K, Koga T, Miyoshi K, Konishi H.
14. J Pain Res. 2015; 8: 523–535.Published online 2015 Aug 12. doi: 10.2147/
JPR.S83599 Patterns of health care utilization for low back pain
Walter F Stewart,1 Xiaowei Yan,1 Joseph A Boscarino,1 Daniel D Maeng,1 Jack
Mardekian,2 Robert J Sanchez,3 andMichael R Von Korff4
15. Pain Physician. 2015 May-Jun;18(3):E333-46. Low back pain: guidelines for the
clinical classification of predominant neuropathic, nociceptive, or centralsensitization
pain. Nijs J1, Apeldoorn A, Hallegraeff H, Clark J, Smeets R, Malfliet A, Girbes EL, De
Kooning M, Ickmans K.
16. Spine J. 2013 Feb;13(2):99-109. doi: 10.1016/j.spinee.2012.10.001. Epub 2012 Nov
3.Spinal fusion for chronic low back pain: systematic review on the accuracy of tests for
patient selection. Willems PC1, Staal JB, Walenkamp GH, de Bie RA.
17. Best Pract Res Clin Rheumatol. 2015 Feb;29(1):6-19. doi: 10.1016/j.berh.
2015.04.024. Epub 2015 May 23. Diagnosing and treating chronic musculoskeletal pain
based on the underlying mechanism(s). Clauw DJ1.

3. 18. Clin J Pain. 2013 Jul;29(7):625-38. doi: 10.1097/AJP.0b013e31826f9a71.
Central sensitization and altered central pain processing in chronic low back pain: fact
or myth? Roussel NA1, Nijs J, Meeus M, Mylius V, Fayt C, Oostendorp R.
19. Curr Rheumatol Rev. 2015;11(2):70-85. Editorial review: an update on central
sensitivity syndromes and the issues of nosology and psychobiology.
Yunus MB1.
20. Spine (Phila Pa 1976). 2015 Aug 1;40(15):E890-9. doi: 10.1097/BRS.
Even Worse - Risk Factors and Protective Factors for Transition from Chronic Localized
Low Back Pain to Chronic Widespread Pain in General Practice: A Cohort Study. Viniol
A1, Jegan N, Brugger M, Leonhardt C, Barth J, Baum E, Becker A, Strauch K.
21. Orthopedics. 2015 Dec 1;38(12):e1065-72. doi: 10.3928/01477447-20151120-02.
Return to Work After Diskogenic Fusion in Workers' Compensation Subjects. Anderson
JT, Haas AR, Percy R, Woods ST, Ahn UM, Ahn NU.