Nociplastic pain is associated with altered nociceptive processing without sufficient explanation from tissue injury activating nociceptors or a somatosensory lesion. The pain is real, requires clinical assessment and may coexist with other pain mechanisms in the same person.
Function and mechanism
The nervous system can process sensory information in ways that support persistent pain. Nociplastic describes this proposed mechanism; it does not mean imaginary pain, a purely psychological disorder or irreversible injury. Biological influences, sleep and context can interact, without one factor necessarily accounting for the complete clinical picture.
Assessment and interpretation
Identification uses several findings, including duration, distribution, hypersensitivity and the adequacy of other explanations. Normal MRI or a positive questionnaire is insufficient. Assessment should consider inflammatory disease, nerve disorders and other relevant causes. Nociceptive or neuropathic mechanisms can also be present, so classification need not assign the whole person to one exclusive category.
Role of TAGMED care
At TAGMED, support can focus on graded activities, independence and shared goals alongside medical care. Any passive techniques should demonstrate useful benefit. Spinal decompression is not a universal correction for altered nociceptive processing, and repeated temporary relief alone does not establish long-term improvement.
Follow-up and warning signs
Follow-up prioritizes participation, sleep and recovery while acknowledging pain. New symptoms need separate assessment; new urinary retention or saddle numbness requires immediate emergency care even when a persistent pain diagnosis is already known.
Frequently asked questions
Does normal imaging confirm this mechanism?
No. A coherent clinical assessment is required, beyond the absence of an imaging abnormality.
Is this psychological pain?
No. The term does not reduce pain to mood or imagination.
Is central sensitization an exact synonym?
No. The concepts are related but describe different aspects of pain processing.
Can psychological support help?
Yes, by supporting function and adaptation without questioning the reality of pain.
Can function improve?
Yes. Individualized progression is possible, although the pace and extent of improvement vary.
This proposed mechanism does not mean imaginary pain or a diagnosis established by a questionnaire alone.
Medical references
- International Association for the Study of Pain. IASP Terminology.
- IASP — PAIN. Chronic nociplastic pain affecting the musculoskeletal system: clinical criteria and grading system.
- IASP — PAIN. The concept of nociplastic pain—where to from here?.
References document the topic; their inclusion does not imply endorsement of TAGMED services by those organizations.
Educational information from The Spine Page. This entry does not replace an individual assessment. Documentary version: October 12, 2026. Sylvain Desforges, B.Sc., D.O., N.D., osteopath and naturopath.
TAGMED clinic contact details
For non-urgent consultations and information about available services.
Clinique TAGMED — Terrebonne
1150, rue Lévis, Suite 200
Terrebonne (Québec) J6W 5S6
450‑704‑4447
Clinique TAGMED — Montréal
1140, avenue Beaumont
Mont-Royal (Québec) H3P 3E5
1‑877‑672‑9060