Nociplastic pain
Nociplastic pain or central sensitisation is a type of pain which is mechanically different from the normal nociceptive pain caused by inflammation and tissue damage or the neuropathic pain which results from nerve damage. It may occur in combination with the other types of pain or in isolation. Its location may be generalised or multifocal and it can be more intense than would be expected from any associated physical cause.
| Nociplastic pain | |
|---|---|
| Other names | Central sensitisation |
| Fibromyalgia is the classic example of nociplastic pain, being diagnosed when pain is felt in four different quadrants of the body using measures such as the Widespread Pain Index shown | |
| Specialty | Neurology |
| Duration | Short to long-term |
| Diagnostic method | Clinical history, description of pain |
| Treatment | Exercise, medication, psychological therapies, pain neuroscience education |
Its causes are not fully understood but it is thought to be a dysfunction of the central nervous system whose processing of pain signals may have become distorted or sensitised.
The concept and term was formally added to the taxonomy of the International Association for the Study of Pain following the recommendation of a task force in 2017. The root terms are Latin nocēre, meaning to hurt, and Greek πλαστός, meaning development or formation in a medical context.
This type of pain typically arises in some chronic pain conditions, with the archetypal condition being fibromyalgia. It may be a factor in long COVID. Exercise is commonly prescribed for such conditions. Nociplastic pain has also been hypothesized to play a role in the persistence of medically unexplained symptoms.