Nociplastic Questionnaire (NociQ): Development and Initial Validation

Nociplastic pain is implicated in many chronic pain conditions, yet it has been defined primarily by the absence of structural causes-a diagnosis by exclusion. No validated nociplastic pain questionnaire exists. This study examined hypothesized pain-specific features of nociplastic pain and developed a brief self-report instrument, the Nociplastic Questionnaire (NociQ).

We generated items based on literature review and input from experts and individuals with lived experience. We administered the items and measures of other pain-related constructs (pain intensity/interference, catastrophizing, kinesiophobia, and perceived stress) to 888 participants with diverse chronic pain conditions.

Factor analyses supported four dimensions captured by internally consistent 4-item subscales (αs ≥0.74): 1) location variability, 2) exacerbation by thoughts and emotions, 3) widespreadness, and 4) allodynia. The NociQ total score adequately discriminated presumed nociplastic and non-nociplastic conditions (AUCs 0.73-0.75). Participants who had widespread pain or reported more presumed nociplastic conditions scored higher on all scales (ps <.001, ds=0.35-1.37). NociQ scales demonstrated small-to-moderate correlations with measures of theoretically distinct constructs (rs=0.10-0.44), supporting discriminant validity, and explained additional variance in pain intensity beyond those measures (ΔR²s=.02-.07; ps <.05), supporting incremental validity.

Results indicate four nociplastic pain characteristics, including two, location variability and exacerbation by thoughts and emotions, psychometrically validated here for the first time. The 16-item NociQ demonstrates promising reliability and validity as a brief questionnaire of nociplastic pain. Future research should examine its clinical utility, such as in matching patients to pain mechanism-targeted treatments.