Chronic pain medical terminology is evolving, to reflect ongoing medical research. The latest term to enter my orbit as a Social Security disability lawyer is nociplastic pain syndrome. Nociplastic pain is a type of chronic pain characterized by altered pain processing in the nervous system, where pain is experienced despite the absence of clear tissue damage or nerve injury.

The term recognizes that there is objective evidence of states in which the nociceptive system is sensitized in the absence of or as a result of chronic nociceptive or neuropathic pain stimuli. Classic amongst these conditions are fibromyalgia and complex regional pain syndrome.

Nociplastic pain is characterized by allodynia, hyperalgesia, spread or migratory character to the distribution of pain, and pain out of proportion to any nociceptive for neuropathic input. This is the result of sensitization within the nociceptive system that can occur throughout the nociceptive chain. The free nerve endings of primary nociceptors can be sensitized, the transmission at the primary to secondary nociceptor synapse, the secondary nociceptor, and the pain neurotag are all sensitized.

Nociplastic pain can exist by itself with no nociceptive or neuropathic pain problem, but also exists in combination with or residual to these other mechanisms of pain, contributing to its prolonged nature.