{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T10:31:05Z","timestamp":1786357865519,"version":"build-2736575974"},"reference-count":174,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>This perspective paper addresses five methodological concerns in clinical investigations across the field of pain research and the paradigm of central sensitization. The first is the conflation of the phenomenon and the measurement tool: a patient reported outcome questionnaire called \u201cCentral Sensitization Inventory\u201d is given as an example. Second, instruments that are used for measuring central sensitization (and its severity) are not validated to measure the phenomenon of central sensitization. The third is conceptual ambiguity regarding the theoretical framework of central sensitization and nociplastic pain, perpetuating the perception of central sensitization\/nociplastic pain as both a phenomenon and a mechanism at the same time. The fourth is the conflation of clinical reasoning with scientific thinking, where in the former jumping from the mechanism to the phenomenon and vice versa is natural. The fifth is terminology issues such as \u201ccentral-sensitivity syndromes\u201d and \u201ccentral sensitization-associated symptoms\u201d when referring to fibromyalgia and similar conditions. In summary, by clinician-researchers confusing empirics with theory and theory with empirics and using clinical reasoning instead of scientific thinking, central sensitization becomes an axiom instead of a paradigm to be investigated according to hypothesis-driven studies. The failure to be aware of and clearly distinguish between these cognitive frameworks can lead to flawed research designs, inappropriate interpretations of findings, groundless mechanistic conclusions, and ultimately compromised clinical decision making.<\/jats:p>","DOI":"10.3390\/jcm15166174","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T09:24:53Z","timestamp":1786353893000},"page":"6174","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Meditations on Methodological Issues in Clinical Investigations of \u201cCentral Sensitization\u201d (Jonah XII)"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5823-3390","authenticated-orcid":false,"given":"Shiloh","family":"Plaut","sequence":"first","affiliation":[{"name":"Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia 2408, Cyprus"},{"name":"Meuhedet Health Services, Jerusalem 9434171, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"104481","DOI":"10.1016\/j.jpain.2024.01.346","article-title":"Mental Health Outcomes of Endometriosis Patients during the COVID-19 Pandemic: Impact of Pre-pandemic Central Nervous System Sensitization","volume":"25","author":"Liu","year":"2024","journal-title":"J. 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