Perspectives

What is nociplastic pain?

Perspectives

What is nociplastic pain?

Milton Cohen

Figures

© marc phares/spl
© marc phares/spl

Abstract

‘Nociplastic’ is a new, additional descriptor for the somatic component of the experience of pain. It identifies that altered nociceptive function in the central nervous system may be relevant to the pathogenesis of chronic pain in particular.

Key Points

  • ‘Nociplastic’ is a new, additional descriptor for the somatic component of the experience of pain.
  • The term differs from ‘nociceptive’ and ‘neuropathic’ by indicating that altered central nociceptive function may be the relevant mechanism of pain.
  • Nociplastic pain may well underlie chronic conditions such as fibromyalgia, complex regional pain syndrome, so-called nonspecific chronic low back pain and irritable bowel syndrome, to name just a few.
  • Nociplastic pain affords validity to patients whose pain is neither nociceptive nor neuropathic, but who have clinical features suggesting altered central nociceptive function; explanatory confidence to their clinicians; and a pathway to improved assessment now and tailored therapies in the future.
  • It is important to distinguish between ‘nociplastic pain’ as a clinical descriptor, ‘chronic primary pain’ as a taxonomic entity and ‘central sensitisation of nociception’ as a pathophysiological process. Not only are these terms not synonymous but also none of them is a ‘diagnosis’.