Identifying and Managing Nociplastic Pain in Individuals With Rheumatic Diseases: A Narrative Review

Arthritis Care Res (Hoboken). 2023 Oct;75(10):2215-2222. doi: 10.1002/acr.25104. Epub 2023 Mar 16.

Abstract

Chronic pain is a burdensome and prevalent symptom in individuals with rheumatic disease. The International Association for the Study of Pain classifies pain into 3 descriptive categories: nociceptive, neuropathic, and nociplastic. These categories are intended to provide information about the mechanisms underlying the pain, which can then serve as targets for drug or non-drug treatments. This review describes the 3 types of pain as they relate to patients seen by rheumatology health care providers. The focus is on identifying individuals with nociplastic pain, which can either occur in isolation as in fibromyalgia, or as a comorbidity in individuals with primary autoimmune conditions, such as rheumatoid arthritis and systemic lupus erythematosus. Practical information about how rheumatology health care providers can approach and manage chronic pain is also provided.

Publication types

  • Review

MeSH terms

  • Arthritis, Rheumatoid*
  • Chronic Pain* / diagnosis
  • Chronic Pain* / epidemiology
  • Chronic Pain* / etiology
  • Comorbidity
  • Fibromyalgia* / diagnosis
  • Fibromyalgia* / epidemiology
  • Fibromyalgia* / therapy
  • Humans
  • Rheumatic Diseases* / complications
  • Rheumatic Diseases* / diagnosis
  • Rheumatic Diseases* / epidemiology