nociplastic pain

• Nociplastic pain:

  • pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain
• Nociplastic pain:

  • pain not from tissue, not from a clear nerve or nerve pathway injury/disease
  • disproportionate, non-mechanical, unpredictable pattern of pain provocation in response to multiple/non-specific aggravating/easing factors
  • pain and tenderness often spread beyond normal boundaries, without a clear anatomical pattern
  • pain disproportionate to the nature and extent of detectable injury or pathology
  • stronger association with psychosocial factors e.g. low mood
  • diffuse/non-anatomic areas of pain/tenderness on palpation
• Nociplastic pain:

  • all it means is:
  • not clearly nociceptive
  • not clearly neuropathic/nerve involvement
  • vague, but reflects that:
  • we know theres various possible mechanisms for why pain might persist and be unpredictable
  • we dont know nearly enough about them yet
  • we cant reliably attribute a specific mechanism to a patients presentation
  • many people will not find it meaningful
  • so best not to use it to explain or label a pts pain