Pain sensitivity questionnaire in endometriosis

Avonae J Gentles; Sarah Wong; Natasha L Orr; Heather Noga; Catherine Allaire; Christina Williams; Mohamed A Bedaiwy; Caroline Lee; John Kramer; Paul J Yong

doi:10.1016/j.jpain.2025.105357

Pain sensitivity questionnaire in endometriosis

J Pain. 2025 May:30:105357. doi: 10.1016/j.jpain.2025.105357. Epub 2025 Mar 4.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada; BC Women's Center for Pelvic Pain and Endometriosis Vancouver, BC, Canada.
² BC Women's Center for Pelvic Pain and Endometriosis Vancouver, BC, Canada; School of Nursing, University of British Columbia, Vancouver, BC, Canada.
³ Women's Health Research Institute, Vancouver, BC, Canada.
⁴ Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada; BC Women's Center for Pelvic Pain and Endometriosis Vancouver, BC, Canada; Women's Health Research Institute, Vancouver, BC, Canada.
⁵ Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, Vancouver Costal Health Research Institute, University of British Columbia, Vancouver, BC, Canada.
⁶ Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada; BC Women's Center for Pelvic Pain and Endometriosis Vancouver, BC, Canada; Women's Health Research Institute, Vancouver, BC, Canada. Electronic address: Paul.Yong@vch.ca.

PMID: 40049377
DOI: 10.1016/j.jpain.2025.105357

Abstract

There is increasing recognition that nociplastic pain and central sensitization may play a role in endometriosis-associated pain. The Pain Sensitivity Questionnaire Minor (PSQ-M) evaluates subjective widespread pain sensitivity, and is linked to pain outcomes in chronic pain populations. However, evidence connecting the PSQ-M to central sensitization in endometriosis is limited. Using the Central Sensitization Inventory (CSI) as a comparison, this study compared the PSQ-M as a clinical proxy for central sensitization in endometriosis individuals. Data collected from 983 endometriosis participants (mean age of 34 years), between January 2020 and December 2022, were analyzed from a prospective registry. A significant but weak positive correlation was observed between PSQ-M and CSI scores (r=0.099, p<0.001). A significant but weak correlation was found between the number of central sensitivity syndromes and pelvic pain-related comorbidities with the PSQ-M (r=0.093, p<0.001), compared to a stronger correlation with the CSI (r=0.687, p<0.05). PSQ-M scores were not significantly associated with baseline (r=0.013, p=0.797) or post-operative (r=-0.046, p=0.801) quality-of-life. There was no change in the PSQ-M and a small change in CSI after endometriosis surgery, suggesting that surgical treatment of endometriosis does not directly address central sensitization. In conclusion, the PSQ-M may not be the optimal clinical proxy for central sensitization in endometriosis. PERSPECTIVE: This study evaluates the Pain Sensitivity Questionnaire - Minor (PSQ-M) as a proxy for central sensitization in endometriosis. The PSQ-M showed weak correlations with central sensitivity syndromes and pain scores and was not associated with post-surgical quality-of-life, suggesting it may not be the optimal tool for assessing central sensitization in endometriosis.

Keywords: Central Sensitivity Syndromes; Central Sensitization; Central Sensitization Inventory; Endometriosis; Pain Sensitivity Questionnaire.

MeSH terms

Adult
Central Nervous System Sensitization* / physiology
Chronic Pain* / diagnosis
Chronic Pain* / etiology
Chronic Pain* / physiopathology
Endometriosis* / complications
Endometriosis* / physiopathology
Female
Humans
Middle Aged
Pain Measurement* / methods
Pain Threshold* / physiology
Pelvic Pain* / diagnosis
Pelvic Pain* / etiology
Pelvic Pain* / physiopathology
Prospective Studies
Registries
Surveys and Questionnaires
Young Adult