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Review
. 2025 Aug;43(3):549-560.
doi: 10.1016/j.ncl.2025.04.005. Epub 2025 Jun 13.

Advances in Our Understanding and Treatment of Nociplastic Pain

Affiliations
Review

Advances in Our Understanding and Treatment of Nociplastic Pain

Bridget R Mueller et al. Neurol Clin. 2025 Aug.

Abstract

Nociplastic pain is a distinct pain mechanism arising from amplified and/or dysregulated sensory processing within the central nervous system (CNS). It is clinically characterized by multisite pain as well as nonpainful symptoms including fatigue, sleep, and memory issues. Although nociplastic pain may be the primary or sole pain mechanism, it often co-occurs as part of a mixed pain syndrome in which nociceptive and neuropathic features are also present. Multimodal therapies grounded in the biopsychosocial model of pain and emphasizing nonpharmacologic treatments alongside pharmacologic interventions acting on the CNS are key to managing nociplastic pain.

Keywords: Central nervous system; Chronic overlapping pain conditions; Chronic pain management; Nociplastic pain.

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Conflict of interest statement

Disclosures Dr D.J. Clauw serves as a Consultant for Merck, Lilly, Tonix, Swing, Virios, and Axsome, and has testified in litigation against opioid manufacturers and distributors.