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Nociplastic Pain - The Third Mechanistic Descriptor: Background, Clinical Applications and Scientific Fundaments

Pain was traditionally regarded as a symptom of tissue injury or disease/lesion in the nervous system, i.e., nociceptive or neuropathic pain. However, certain forms of chronic pain are best regarded as a condition or disease in their own right, i.e. primary pain.
The third mechanistic descriptor, nociplastic pain, defined as pain that arises from altered nociception, permits the mechanistic classification of “primary” pain. The new matrix of IASP mechanistic terms, nociceptive, neuropathic, nociplastic and pain of unknown origin will be presented along with a discussion how these terms should be used in the clinic. The presentations will provide an overview of the variety of pain conditions associated with nociplastic pain and the potential clinical and scientific usefulness of the new term. The underlying pathophysiological mechanisms as well as clinical signs and symptoms in musculoskeletal and visceral nociplastic pain will be presented. The transition from nociceptive to nociplastic musculoskeletal pain, how it can be recognized, and the relevance for treatment will be discussed. The unique features of disturbed visceroception with underlying psychological and neural mechanisms along the brain-gut axis will be highlighted.
Finally, the audience will be invited to discuss future development of clinically useful positive diagnostic criteria for nociplastic pain.

Learning Objectives:

  • Upon completion of this session attendees will be updated regarding the principles of IASPs new mechanistic pain classification, i.e., when to use nociceptive, neuropathic and nociplastic pain descriptors.
  • Upon completion of this session attendees will be familiar with the underlying pathophysiological mechanisms, the broad variety of musculoskeletal pain conditions and clinical signs and symptoms of musculoskeletal nociplastic pain.
  • Upon completion of this session attendees will understand the enormous clinical relevance of disturbed visceroception and be familiar with the most common clinical conditions associated with nociplastic visceral pain.

Credit: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Annenberg Center for Health Sciences at Eisenhower and the International Association for the Study of Pain. The Annenberg Center for Health Sciences at Eisenhower is accredited by the ACCME to provide continuing medical education for physicians.

The Annenberg Center for Health Sciences at Eisenhower designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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