Abstract

Background: Chronic low back pain (CLBP) is the leading cause of disability worldwide and is increasingly recognized as a condition characterized by central sensitization (CS). Despite the growing evidence of CS as a multidimensional driver of pain, psychosocial dysfunction, and physical impairment, research on the Indian population, particularly Gujarati-speaking adults, is scarce. Objective: To investigate the association between CS and pain intensity, fear–avoidance beliefs (FABs), functional disability, back extensor muscle endurance, and depression in Gujarati-speaking adults with CLBP. Methods: This cross-sectional study included 150 adults (102 females, 48 males; mean age, 42.30 ± 10.24 years) with CLBP from multiple physiotherapy and orthopedic clinics in Surat, Gujarat, India. CS was measured using the Central Sensitization Inventory Gujarati version (CSI-G). Additional instruments included the Numerical Pain Rating Scale (NPRS), Fear-Avoidance Beliefs Questionnaire–Gujarati (FABQ-G), Oswestry Disability Index–Gujarati (ODI-G), Extensor Endurance Test (EET), and Patient Health Questionnaire-9–Gujarati (PHQ-9-G). Pearson’s correlation and multiple linear regression analyses were performed using IBM SPSS v20.0. Results: CS was positively correlated with pain intensity (r = 0.869, p < 0.001), FABs (r = 0.840, p < 0.001), disability (r = 0.825, p < 0.001), and depression (r = 0.730, p < 0.001) and negatively correlated with back extensor endurance (r = −0.390, p < 0.001). Regression analysis identified pain intensity (β = 0.384), disability (β = 0.248), depression (β = 0.183), and fear-avoidance beliefs (FABs) (β = 0.174) as significant predictors of CS. Extensor endurance was not a significant independent predictor (p = 0.229). Conclusion: CS is very strongly associated with pain, psychosocial distress, and disability in Gujarati-speaking patients with CLBP. CS screening and biopsychosocial assessment should be routine in CLBP management, and interventional research is needed to test targeted treatments.

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