Nociplastic Pain: Facts, Controversies and Future Tasks

Area of Science:

• Pain Medicine
• Neurology
• Clinical Research

Background:

• Nociplastic pain is defined as pain arising from altered nociception, not fully explained by nociceptive or neuropathic mechanisms.
• It represents a third mechanistic pain descriptor alongside nociceptive and neuropathic pain.

Purpose of the Study:

• To summarize and extend discussions on nociplastic pain from the European Pain Federation EFIC conference.
• To address controversies and clarify the concept of nociplastic pain.

Main Methods:

• Summary and extension of discussions from a main session at the European Pain Federation EFIC conference.
• Analysis of existing concepts and terms related to nociplastic pain.

Main Results:

• Nociplastic pain is not synonymous with chronic primary pain or central sensitization.
• The term 'nociplastic' and its diagnostic criteria, particularly the exclusion of other pain types, have been questioned.
• Fibromyalgia syndrome is not exclusively a nociplastic pain condition.

Conclusions:

• Further research is needed to refine criteria for nociplastic pain.
• Development of treatment guidelines based on the three pain types is essential.
• Unifying concepts across somatic, psychosocial, and pain medicine is a future task.