Advances in Our Understanding and Treatment of Nociplastic Pain

Nociplastic pain is a distinct pain mechanism arising from amplified and/or dysregulated sensory processing within the central nervous system (CNS). It is clinically characterized by multisite pain as well as nonpainful symptoms including fatigue, sleep, and memory issues. Although nociplastic pain may be the primary or sole pain mechanism, it often co-occurs as part of a mixed pain syndrome in which nociceptive and neuropathic features are also present. Multimodal therapies grounded in the biopsychosocial model of pain and emphasizing nonpharmacologic treatments alongside pharmacologic interventions acting on the CNS are key to managing nociplastic pain.