Nociplastic pain: an introduction

Chronic pain is common in chiropractic practice and often presents without clear evidence of tissue injury. Nociplastic pain is a recently defined concept that highlights altered nociceptive processing within the nervous system. This newer understanding of pain provides insight into chronic conditions such as chronic back or neck pain, chronic headaches, and fibromyalgia. These conditions are commonly encountered in chiropractic practice but may be challenging to address using traditional models. This commentary introduces nociplastic pain, outlining potential mechanisms and relevance to chiropractic care. We advocate a collaborative, multimodal management approach that includes patient education, exercise promotion, and functional goal-setting within a biopsychosocial framework. Understanding nociplastic pain equips chiropractors to support patients with complex chronic pain through compassionate, evidence-based care that addresses the whole person.