Breaking the Pain Cycle: Amplifier Loops, Central Sensitization, and a CSI-Guided Clinical Decision Framework — A Scoping Review and Clinical Framework Proposal
Arranz-Durán, Javier; Koovor, Eswary; Abejón-González, David; Domingo-Rufes, Tomás; González, Enrique; Horas-Barrera, Carlos;
Breaking the Pain Cycle: Amplifier Loops, Central Sensitization, and a CSI-Guided Clinical Decision Framework — A Scoping Review and Clinical Framework Proposal
Scoping review (PRISMA-ScR) mapping four amplifier loops sustaining central sensitization in chronic pain and proposing a CSI-stratified clinical decision framework. 63 verified references in AMA format, ~5,000 words body text. Includes charting table (Supplementary Table 1), PRISMA-ScR checklist (Supplementary Table 2), and excluded studies summary (Supplementary Table 3). Submitted to Pain Medicine (Oxford). OSF protocol: https://osf.io/jrxaq/