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

Authors: 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

Abstract

DEFINITIVE VERSION. Scoping review (PRISMA-ScR) + clinical framework proposal. 66 references (AMA format, all PubMed-verified). GRADE evidence table for all clinical recommendations. Part A (evidence mapping) / Part B (framework proposal) structure. Abstract 245 words, body ~4,800 words. Submitted to Pain Medicine (Oxford/AAPM). OSF: https://osf.io/jrxaq/

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