Does central sensitization affect disease severity and spinal mobility in axial spondyloarthritis?

Abstract

Objectives: The aim of this study was to investigate the relationships between central sensitization and disease activity, functional status, and spinal mobility in individuals with axial spondyloarthritis, and to elucidate the role of central pain mechanisms in the clinical presentation. Materials and Methods: This cross-sectional observational study included 30 individuals aged 18–65 years diagnosed with axial spondyloarthritis. Disease activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional status with the Bath Ankylosing Spondylitis Functional Index (BASFI), spinal mobility with the Bath Ankylosing Spondylitis Metrology Index (BASMI), central sensitization with the Central Sensitization Inventory (CSI), and pain catastrophizing with the Pain Catastrophizing Scale (PCS). Relationships between variables were analyzed using Spearman correlation analysis (p <0.05). Results: A moderate positive correlation was found between central sensitization and spinal mobility (r = 0.388; p = 0.034). CSI scores were also moderately positively correlated with functional status (r = 0.371; p = 0.044). However, no significant relationship was observed between central sensitization and disease activity (p> 0.05). Pain catastrophizing was not significantly associated with either clinical parameters or central sensitization. Conclusion: This study demonstrates that central sensitization in axial spondyloarthritis is particularly associated with functional limitation and spinal mobility, but may not parallel disease activity. These findings highlight the importance of considering central pain mechanisms beyond inflammatory indicators in disease assessment and emphasize the role of multidisciplinary, biopsychosocial-based rehabilitation approaches in clinical management.

Keywords

• axial spondyloarthritis
• central sensitization
• spinal mobility
• functional status
• disease activity

Ethical Statement

The research was planned as a cross-sectional study and received approval from the Non-Interventional Ethics Committee of Istanbul Atlas University (Date: 29.09.2025, Decision No: 08/07).

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