Part of pain labelled neuropathic in rheumatic disease might be rather nociplastic
Open accessAbstract
Pain in rheumatic diseases is primarily due to mechanical or inflammatory mechanism, but neuropathic pain (NP) component is also occurring in many conditions and is probably underdiagnosed. The purpose of this article is to provide an overview of prevalence, pathophysiological and currently available treatment of NP in rheumatic diseases. When associated with clinical evaluation assessing neurological clinical signs and neuroanatomical distribution, Douleur Neuropathique 4 Questions, painDETECT, Leeds assessment of neuropathic symptoms and signs and Neuropathic Pain Questionnaire can detect NP component. Inflammatory or connective diseases, osteoarthritis, back pain or persistent pain after surgery are aetiologies that all may have a neuropathic component. Unlike nociceptive pain, NP does not respond to usual analgesics such as paracetamol and non-steroidal anti-inflammatory drugs. Entrapment neuropathy, peripheral neuropathy or small-fibre neuropathy are different aetiologies that can lead to NP. A part of the pain labelled neuropathic is rather nociplastic, secondary to a central sensitisation mechanism. Identifying the right component of pain (nociceptive vs neuropathic or nociplastic) could help to better manage pain in rheumatic diseases with pharmacological and non-pharmacological treatments.
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The model is consistent with the new concept of nociplastic pain.
“First, it is consistent with the new concept of nociplastic pain [134,135]”
From Fibromyalgia pathogenesis explained by a neuroendocrine multistable model (2024) · cites this paper as [134]
The ‘Differences between neuropathic and nociplastic pain’ section describes nociplastic pain as a proposed third mechanism of chronic pain and links it to central sensitisation. The paper does not assess whether the citing document’s unspecified model is consistent with that concept. No page number is available in our copy. (LLM, conf=0.78)
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- Authors
- Bailly, F., Cantagrel, A., Bertin, P., Perrot, S., Thomas, T., Lansaman, T., Grange, L., Wendling, D., Dovico, C., & Trouvin, A.-P.
- Affiliations
- Assistance Publique – Hôpitaux de Paris (FR)
- Centre Hospitalier Universitaire de Toulouse (FR)
- Hôpital Universitaire Dupuytren (FR)
- Inserm (FR)
- Centre Hospitalier Universitaire de Saint-Étienne (FR)
- Centre Hospitalier Universitaire de Grenoble (FR)
- Centre Hospitalier Universitaire de Besançon (FR)
- Service De Médecine Physique Et Réadaptation, Dispositif IEM APF FRANCE HANDICAP, Belfort, France
- Corresponding author
- Bailly, Florian
- ORCID
- Venue
- RMD Open
- Publisher
- BMJ
- Published
- 2020-09
- Volume
- 6
- Issue
- 2
- Pages
- e001326
- ISSN
- 2056-5933 (ISSN-L)
- PMC
- PMC7508212
- OpenAlex
- W3083396528
- Cited by
- 73
- References
- 51
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 10 · 2023: 15 · 2022: 13 · 2021: 15
- FWCI
- 1.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- RMD Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by-nc)
- HAL (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Grünenthal
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- neuropathic pain, rheumatic diseases, nociplastic pain, central sensitization, pain assessment, painDETECT, neuropathic pain treatment, nerve entrapment, peripheral neuropathy, small fiber neuropathy, osteoarthritis, postoperative pain, back pain, nociceptive pain
- MeSH terms
- Disease Susceptibility, Humans, Neuralgia, Pain Measurement, Rheumatic Diseases, Prevalence, Disease Management, Patient Outcome Assessment
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