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Concept
Nociplastic pain
Summary
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.
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.
Nociplastic pain is a longterm complex pain, one of three mechanisms of pain, defined by the International Association for the Study of Pain as "pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain". The other two mechanisms are nociceptive pain and neuropathic pain. Widespread pain and increased pain have been suggested as important clinical features.
Central sensitization is a broader term referring to a hyperexcitability of the nervous system, usually including hyperalgesia (increased sensitivity to pain), and allodynia (painful perception of non-painful stimuli).
An even broader term is that of central sensitivity syndromes, referring to syndromes characterized by the hyperexcitement of central neurons.
Official source
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