Nociplastic pain: towards an understanding of prevalent pain conditions

  title={Nociplastic pain: towards an understanding of prevalent pain conditions},
  author={Mary-Ann Fitzcharles and Steven P. Cohen and Daniel J. Clauw and Geoffrey Owen Littlejohn and Chie Usui and Winfried H{\"a}user},
  journal={The Lancet},
Cannabis-Based Medicines and Medical Cannabis in the Treatment of Nociplastic Pain
The understanding of nociplastic pain is explained, the evidence for the effect of cannabinoids in these conditions is examined, and simplified guidance is provided for healthcare providers who may consider prescribing cannabinoids for these conditions.
Implications of hedonic effects of opioids in clinical practice
Nociplastic pain harmonizes with the current view that certain forms of chronic pain are best understood as conditions or diseases of their own, rather than symptoms of other underlying pathology or disease, reflected in ICD-11 classification of primary pain (disease) and secondary pain (symptom).
Nociplastic Pain in Multiple Sclerosis Spasticity: Dermatomal Evaluation, Treatment with Intradermal Saline Injection and Outcomes Assessed by 3D Gait Analysis: Review and a Case Report
The diagnosis of nociplastic pain on the cutaneous tissue of the anterolateral region of the left thigh and its treatment with intradermal normal saline injection showed immediate and lasting effects on pain and spasticity, improving significantly the patient’s balance and walking, as assessed by a 3D motion analysis and rating scales.
The impact of nociplastic pain features on the response to physical therapy in patients with primary myofascial pain.
The degree of nociplastic pain in patients with myofascial pain appears to be inversely related to improvements from a peripherally based treatment.
Nociplastic pain concept, a mechanistic basis for pragmatic approach to fibromyalgia
A novel approach to early FM diagnosis and management based on NP conceptualization and phenotype recognition is postulate, which provides a broader viewpoint beyond FM delimitation to pain generalization and polysymptomatic complaints.
Mechanism of Chronic Pain of Symptomatic Hip Osteoarthritis by Association of its Distribution, Nociceptive, Neuropathic, Nociplastic, or Mixed-pain Screening, and the Prevalence of Lumbar Spinal Stenosis
Among patients with symptomatic hip OA, the distribution of pain was various, and about 23% of patients had neuropathic, nociplastic, or mixed pain as a possibility for somatosensory system disturbances.
Neuroplasticity related to chronic pain and its modulation by microglia
The mechanisms underlying neuroplasticity that occur in the somatosensory circuit of the spinal dorsal horn, thalamus, and cortex associated with chronic pain following injury to the peripheral nervous system (PNS) or CNS are highlighted and suggested to shed light on the differential mechanisms underlying nociceptive, neuropathic, and nociplastic-type pain.


The role of centralised pain in osteoarthritis.
While osteoarthritis is generally considered a peripherally mediated pain state, a subset of these patients also manifests centrally driven pain characteristics and this requires a more tailored approach to treatment.
Axial Low Back Pain: One Painful Area – Many Perceptions and Mechanisms
From data used to estimate whether neuropathic pain contributes to axial low back pain and if so to what extent, sensory profiles based on descriptor severity may serve as a better predictor for therapy assessment than pain intensity or sole diagnosis alone.
Evidence of augmented central pain processing in idiopathic chronic low back pain.
At equal levels of pressure, patients with CLBP or fibromyalgia experienced significantly more pain and showed more extensive, common patterns of neuronal activation in pain-related cortical areas, consistent with the occurrence of augmented central pain processing in patients with idiopathic CLBP.
The role of sleep in pain and fibromyalgia
  • E. Choy
  • Medicine, Psychology
    Nature Reviews Rheumatology
  • 2015
Clinical trials of pharmacological and nonpharmacological therapies have shown that improving sleep quality can reduce pain and fatigue, further supporting the hypothesis that sleep dysfunction is a pathogenic stimulus of fibromyalgia.
Current understanding of the mixed pain concept: a brief narrative review
This paper summarizes the group’s consensus on several key aspects of the mixed pain concept, to serve as a foundation for future attempts at generating a mechanistic and/or clinical definition of mixed pain.
Decreased Central μ-Opioid Receptor Availability in Fibromyalgia
It is demonstrated that FM patients display reduced MOR binding potential within several regions known to play a role in pain modulation, including the nucleus accumbens, the amygdala, and the dorsal cingulate, which indicates altered endogenous opioid analgesic activity in FM.
The IASP classification of chronic pain for ICD-11: chronic primary pain
The goal here is to create a classification that is useful in both primary care and specialized pain management settings for the development of individualized management plans, and to assist both clinicians and researchers by providing a more accurate description of each diagnostic category.
Endogenous opioidergic dysregulation of pain in fibromyalgia: a PET and fMRI study
It is suggested that dysregulation of the endogenous opioid system in FM could lead to less excitation in antinociceptive brain regions by incoming noxious stimulation, resulting in the hyperalgesia and allodynia commonly observed in this population.