The International Association for the Study of Pain defines nociplastic pain as pain that arises from altered nociception, despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors, or evidence of disease or lesion of the somatosensory system causing the pain. Nociplastic pain is associated with primary pain syndromes such as chronic widespread pain, fibromyalgia, complex regional pain syndrome, chronic primary headache and orofacial pain, chronic visceral pain syndromes and chronic primary musculoskeletal pain. It often occurs together with nociceptive and/or neuropathic pain. According to epidemiological studies, 5–15% of the adult population is affected by nociplastic pain, with women being affected more frequently. Inflammation, changes in monoaminergic networks, and alterations in toll-like receptor function occur in the central and peripheral nervous systems, affecting pain signaling and the immune response. Nociplastic pain is characterized by widespread pain at multiple sites that persists for more than three months. It is accompanied by hypersensitivity to touch, movement, temperature changes, and possibly increased sensitivity to sounds, smells and light, as well as sleep disturbances, fatigue, and cognitive impairment. Recognition of nociplastic pain and the application of an appropriate interdisciplinary, personalized therapeutic approach are crucial for the treatment of patients with chronic pain.
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