Papers in top journals or with thousands of citations (‘central sensitization’ is another word for neuroplastic pain)
As a final‐year PhD researching chronic pain, I’d clarify that central sensitization (Woolf & King, 1989) is strictly a mechanistic term for central hyperexcitability, whereas nociplastic pain (IASP, 2017) is the clinical category applied when central sensitization and/or other mechanisms drive pain despite no detectable tissue damage.
Nociplastic pain is another category of pain, different from nociceptive and neuropathic pain, which applies when it cannot be fully explained by pain mechanisms from the latter groups.
That said, it also depends on our ability to identify the underlying causes. For example, consider trigeminal neuralgia: most cases are caused by vascular compression of the trigeminal root, a clear structural lesion, so they meet the definition of neuropathic pain. However, before we had high-resolution MRI or surgical confirmation, many of those could have been mis-labeled as “neuroplastic” simply because the lesion wasn’t detectable.
Also, we shouldn’t label nociplastic pain the “single most common” cause of chronic pain without compelling, large-scale prevalence data.
As a final‐year PhD researching chronic pain, I’d clarify that central sensitization (Woolf & King, 1989) is strictly a mechanistic term for central hyperexcitability, whereas nociplastic pain (IASP, 2017) is the clinical category applied when central sensitization and/or other mechanisms drive pain despite no detectable tissue damage.
Nociplastic pain is another category of pain, different from nociceptive and neuropathic pain, which applies when it cannot be fully explained by pain mechanisms from the latter groups.
That said, it also depends on our ability to identify the underlying causes. For example, consider trigeminal neuralgia: most cases are caused by vascular compression of the trigeminal root, a clear structural lesion, so they meet the definition of neuropathic pain. However, before we had high-resolution MRI or surgical confirmation, many of those could have been mis-labeled as “neuroplastic” simply because the lesion wasn’t detectable.
Also, we shouldn’t label nociplastic pain the “single most common” cause of chronic pain without compelling, large-scale prevalence data.