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Nociplastic Pain: A Critical Paradigm for Multidisciplinary Recognition and Management
1Tel Aviv Sourasky Medical Center, Tel Aviv University, 6 Weizmann St., Tel Aviv 69978, Israel.
Journal of Clinical Medicine
|October 16, 2024
Summary
Nociplastic pain, defined by the International Association for the Study of Pain (IASP), arises from altered central nervous system pain modulation, not tissue damage. Recognizing this complex pain syndrome is vital for effective, multidisciplinary chronic pain management.
Area of Science:
- Neuroscience
- Pain Medicine
- Rheumatology
Background:
- Chronic pain understanding evolved from peripheral damage to central nervous system mechanisms.
- Nociplastic pain, defined by IASP (2017), involves altered pain modulation without clear tissue damage.
- Historical progression: fibrositis -> fibromyalgia -> nociplastic pain, highlighting complexity.
Purpose of the Study:
- Explore the concept and characteristics of nociplastic pain.
- Discuss neuroimaging findings and controversies in nociplastic pain.
- Emphasize clinical recognition and emerging therapies for nociplastic pain.
Main Methods:
- Perspective article synthesizing current understanding of nociplastic pain.
- Review of neuroimaging studies on brain network alterations.
- Discussion of clinical implications and therapeutic advancements.
Main Results:
- Nociplastic pain involves central sensitization and comorbidities (fatigue, sleep issues, cognitive difficulties).
- Neuroimaging shows altered brain network connectivity (default mode, salience networks).
- Controversies exist regarding small fiber neuropathy and autonomic dysfunction.
Conclusions:
- Recognizing nociplastic pain is crucial across medical disciplines for improved patient outcomes.
- Multidisciplinary and patient-centered approaches are essential for management.
- Further research into mechanisms, diagnostics, and novel therapies is needed.
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