When pain persists beyond the normal expected healing time, chronic pain is considered a maladaptive response within the central nervous system (brain & spinal cord) and serves no purpose.(1) Many chronic pain conditions result from an amplification within the central nervous system rather than peripheral tissue damage. In addition to the prototypical nociplastic pain condition of fibromyalgia, a number of other conditions such as chronic fatigue, irritable bowel disease, jaw pain, chronic low back pain, and other pain conditions have centralized pain features.(2,17)

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These amplified changes within the central nervous system are considered to be Top-Down (PRIMARY) nociplastic pain. You should consult with your medical providers to rule out potential underlying Bottom-Up (SECONDARY) causes of your chronic widespread pain, such as a rheumatologic, neurologic, connective tissue disorder, endocrine, infectious disease, or a medication side effects. While it is important to identify and treat a secondary cause of nociplastic pain, the strategies to turn down pain are similar for both PRIMARY or SECONDARY nociplastic pain.(3)

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NOTE: Nociplastic Pain may also be referred by some providers as "Neuroplastic Pain", "Centralized Pain", "Central Sensitization", or "Pain Amplification"