Research progress of nociplastic pain in the clinical treatment of chronic pain diseases

Abstract

Chronic pain is increasingly developing into a worldwide health problem. Due to the money and treatment required for care and rehabilitation, as well as the complexity of the various types of pain, chronic pain sufferers often bear a huge financial burden as well as a psychological one. According to statistics, 23% of chronic pain sufferers have suicidal thoughts. In 2017, the third category pain named "nociplastic pain" was proposed for the first time by the International Association for the Study of Pain (IASP) which is disparate with the first kind nociceptive pain and the second pain neuropathic. The physiological mechanisms behind this type of pain are not known. However, it is commonly thought to be associated with a hypersensitivity response in the central nervous system and can be resulted in chronic nociceptive pain, so nociplastic pain is able to occur by itself, and can combine with other pain. At the same time, this type of pain affects the central system and produces other derived symptoms. Examples include stimulation of the limbic system, including impaired processing of emotions by the amygdala, amplified pain perception, sleep disturbances, increased fatigue and sensitivity to external environmental stimuli. There are no very clear and obvious diagnostic criteria or methods, and clinical detection is difficult. Due to the many symptoms, patients usually undergo multiple tests, with high medical costs and a poor prognosis. Patients suffer both physical and psychological distress. The disease with its complexity characteristic leads the difficulty for doctors to diagnosis it plagues patients with the condition, while increasing the difficulty of medical diagnosis and the cost of medical treatment. This article synthesizes the existing developments in outcomes in nociplastic pain from introduction and classification to diagnosis and treatment, it discusses the existing research findings.