Clinical term
Nociplastic pain
Nociplastic pain is pain arising from altered nociception, without clear evidence of tissue damage activating nociceptors, or of a lesion or disease of the somatosensory system sufficient to explain the pain.
Scientific basis
Proposed in 2016 and adopted by the IASP in 2017, this third mechanistic descriptor complements nociceptive and neuropathic pain. Fibromyalgia is often cited as an example; other chronic pain conditions, including some cases of low back pain, may involve a nociplastic component. Clinical criteria for musculoskeletal pain were proposed in 2021.
The absence of a lesion sufficient to explain the pain does not mean that no abnormality exists in the person. Central sensitization can contribute to nociplastic pain and is frequently observed in it, but it is neither a synonym for it nor a specific mechanism, nor one sufficient on its own; the mechanisms remain an active field of research. The expression “neuroplastic pain”, sometimes used in popular writing, does not correspond to the IASP term.
Blue Portance / SBNFA™ reading
Nociplastic pain is neither imaginary nor psychological: it reflects a change in how nociception is processed. SBNFA™ looks at the mechanical and sensory conditions the body is in, without claiming to act on this mechanism. The Blue Portance model of neurosensory deprogramming offers a distinct functional reading, which is not to be conflated with this category.
Contribution to the analysis of sitting
When pain does not track the intensity of support loads, seating analysis provides information about tolerance to the duration and variability of support. It cannot identify nociplastic pain, whose diagnosis relies on clinical criteria.
Not to be confused with
Central sensitization, a neurophysiological mechanism that can contribute to nociplastic pain without being synonymous with it; nociceptive pain, linked to activation of nociceptors by tissue damage; neuropathic pain, linked to a lesion or disease of the somatosensory system; psychogenic pain, a distinct notion: nociplastic pain is not “psychological” pain.
Related terms
Neurosensory deprogramming · Chronic pain · Neuropathic pain · Nociceptive pain · Fibromyalgia · Central sensitization
Sources and scope
- IASP: pain terminology (reference definitions)
- Kosek et al. (2016): do we need a third mechanistic descriptor for chronic pain states? (Pain)
- Kosek et al. (2021): chronic nociplastic pain affecting the musculoskeletal system, clinical criteria and grading system (Pain)
- Fitzcharles et al. (2021): nociplastic pain, towards an understanding of prevalent pain conditions (Lancet)
Mechanistic descriptor adopted by the IASP in 2017. Its mechanisms are still under investigation; diagnosis relies on clinical criteria.
Further reading
- Learn more — Article: Part 1: Why Does Pain Persist When Everything Seems Normal?
