Central Sensitization Inventory, CSI-R Test - the question form
Questions: 25 · 5 minutes
Select Questionnaire Type
Male form
Female form
1. I feel tired and unrefreshed when I wake up.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
2. I feel muscle tension/stiffness and pain.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
3. I have episodes of anxiety.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
4. I grind my teeth or clench them.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
5. I have bowel problems (diarrhea and/or constipation).
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
6. I need help with everyday activities.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
7. I am sensitive to bright light.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
8. I get tired very quickly from physical activity.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Always
9. I feel pain all over my body.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Always
10. I have headaches.
Never
Rarely
Sometimes
Often
Always
11. I feel bladder discomfort and/or a burning sensation when urinating.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
12. I sleep poorly.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
13. I have difficulty concentrating.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
14. I have skin problems (dryness, itching, rashes).
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
15. Stress makes my physical symptoms worse.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
16. I feel sad or depressed.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
17. I have little energy.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Always
18. My neck and shoulder muscles feel tense.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
19. I have jaw pain.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
20. Certain smells, such as perfume, make me feel dizzy and nauseated.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Always
21. I have to urinate frequently.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
22. I have discomfort in my legs and “restless legs syndrome” when I try to fall asleep at night.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
23. I have difficulty remembering things.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
24. I experienced a traumatic event during childhood.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
25. I have pain in the pelvic area.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
1. I feel tired and unrefreshed when I wake up.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
2. I feel muscle tension/stiffness and pain.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Always
3. I have episodes of anxiety.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
4. I grind my teeth or clench my jaw.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
5. I have problems with bowel movements (diarrhea and/or constipation).
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
6. I need help with everyday daily activities.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
7. I am sensitive to bright light.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
8. I get tired very quickly from physical activity.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
9. I have pain all over my body.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Always
10. I have headaches.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Always
11. I feel bladder discomfort and/or a burning sensation when urinating.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
12. I sleep poorly.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
13. I have difficulty concentrating.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Always
14. I have skin problems (dryness, itching, or rashes).
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
15. Stress makes my physical symptoms worse.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
16. I feel sad or depressed.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
17. I have low energy.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
18. My neck and shoulder muscles feel tense.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
19. I have jaw pain.
Never
Rarely
Sometimes
Often
Always
20. Certain smells, such as perfume, make me feel dizzy and nauseated.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
21. I have to urinate frequently.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
22. I have leg discomfort and “restless legs syndrome” when I am trying to fall asleep at night.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
23. I have difficulty remembering things.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
24. I experienced a traumatic event during childhood.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
25. I have pain in the pelvic area.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always