{"id":13953,"date":"2023-10-12T23:17:03","date_gmt":"2023-10-12T21:17:03","guid":{"rendered":"https:\/\/osteopathie-liem.de\/noziplastic-pain-what-to-do\/"},"modified":"2023-10-12T23:17:03","modified_gmt":"2023-10-12T21:17:03","slug":"noziplastic-pain-what-to-do","status":"publish","type":"post","link":"https:\/\/osteopathie-liem.de\/en\/noziplastic-pain-what-to-do\/","title":{"rendered":"Noziplastic pain &#8211; what to do?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Nociplastic pain is the semantic term proposed by the international pain research community to describe a third category of pain that is mechanistically distinct from nociceptive pain, which is caused by persistent inflammation and tissue damage, and neuropathic pain, which is caused by nerve damage.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The mechanisms underlying this type of pain are not yet fully understood, but it is assumed that increased pain and sensation processing in the CNS and altered pain modulation play an important role.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Symptoms may include: multifocal pain that is more widespread or more intense, or both, than would be expected given the extent of identifiable tissue or nerve damage, as well as other CNS-related symptoms such as fatigue, sleep, memory and mood problems.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">This type of pain can occur in isolation, as is often the case in conditions such as fibromyalgia or tension-type headaches, or as part of a mixed pain condition in combination with persistent nociceptive or neuropathic pain, as can occur in chronic low back pain.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">It is important to recognize this type of pain as it responds to different therapies than nociceptive pain, as it responds less well to peripheral therapies such as anti-inflammatory drugs and opioids, surgery or injections.<\/span><span style=\"font-weight: 400;\"><\/p>\n<p><\/span><\/p>\n<p><a href=\"https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2023\/10\/Noziplastischer-Schmerz-%E2%80%93-was-tun.png\"><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter wp-image-12736 size-full\" src=\"https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2023\/10\/Noziplastischer-Schmerz-%E2%80%93-was-tun.png\" alt=\"\" width=\"304\" height=\"512\"><\/a><\/p>\n<p><b>Overarching principles for the treatment of nociplastic pain<\/b><b><br \/>\n<\/b><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Trusting doctor-patient relationship<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Psychoeducation (explanations using terms such as &#8220;overstimulated&#8221;, &#8220;sensitized&#8221; or &#8220;excited&#8221; nervous system, explanation of treatment strategies<\/span><span style=\"font-weight: 400;\"> and development of <\/span><span style=\"font-weight: 400;\">realistic expectations)<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Promotion of self-management and self-regulation  <\/span><\/li>\n<li><span style=\"font-weight: 400;\">Promotion of good lifestyle habits (health-related physical activity, nutrition and weight management, sleep hygiene<\/span><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">stress reduction)<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Psychological approaches (cognitive-behavioral therapy, acceptance-based therapies<\/span><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">hypnotherapy or psychodynamic therapies)<\/span><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Psychiatric-psychotherapeutic treatment of psychological comorbidities <\/span><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Physical therapies, osteopathy (insertion of Liem), chiropractic, acupuncture, massage or<\/span> <span style=\"font-weight: 400;\">naturopathy<\/span><\/span><\/span><\/li>\n<li><span style=\"font-weight: 400;\">Pharmacological treatments as a second step (e.g. <\/span><span style=\"font-weight: 400;\">z<\/span><span style=\"font-weight: 400;\">entally acting drugs (pain modulators), tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, gabapentinoids and other membrane stabilizers)<\/span><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Simple analgesics and non-steroidal anti-inflammatory drugs have little effect<\/span><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">opioids should be avoided<\/span><\/span><\/span><\/li>\n<li><span style=\"font-weight: 400;\">Neuromodulation  <\/span><\/li>\n<li><span style=\"font-weight: 400;\">Interdisciplinary support<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400; color: #a3a3a3;\">Fitzcharles MA, Cohen SP, Clauw DJ, Littlejohn G, Usui C, H\u00e4user W. Nociplastic pain: towards an understanding of prevalent pain conditions.<br \/>\nLancet.<br \/>\n2021 May 29;397(10289):2098-2110.    <\/span><\/p>\n<p><a href=\"https:\/\/pubmed.ncbi.nlm\"><span style=\"font-weight: 400;\">https:\/\/pubmed.ncbi.nlm<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nociplastic pain is the semantic term proposed by the international pain research community to describe a third category of pain that is mechanistically distinct from nociceptive pain, which is caused by persistent inflammation and tissue damage, and neuropathic pain, which is caused by nerve damage.  <\/p>\n","protected":false},"author":3,"featured_media":13956,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":14,"footnotes":""},"categories":[76],"tags":[],"class_list":["post-13953","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-osteopathy"],"acf":[],"_links":{"self":[{"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/posts\/13953","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/comments?post=13953"}],"version-history":[{"count":0,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/posts\/13953\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/media\/13956"}],"wp:attachment":[{"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/media?parent=13953"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/categories?post=13953"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/tags?post=13953"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}