Your chronic pain
may be nociplastic.
When the tests and scans do not explain your pain, the cause may be the way your nervous system processes it.
Learn what nociplastic pain is, how it is treated, and whether it could be what you are living with.
What is nociplastic pain?
Most of us learned that pain means damage. That holds for acute pain. In chronic pain, the nervous system can learn pain and keep producing it after the tissue has healed, or when little damage was ever found.
Pain scientists call this nociplastic pain. It is thought to sit behind a wide range of conditions where no structural damage clearly explains the pain.
It is real pain.
It does not mean the pain is imaginary or “all in your head”. Studies, including work using brain imaging, show changes in how the nervous system processes persistent pain.
The 3 types of pain
Nociceptive
Pain from actual or threatened tissue damage, such as a sprained ankle or an inflamed joint.
Neuropathic
Pain from a lesion or disease of the nerves that carry sensory signals, such as nerve compression.
Nociplastic
Pain from altered pain processing, without clear evidence of tissue damage or nerve disease. Routine work-ups mostly look for the first two.
How it is treated
Pain Reprocessing Therapy
Pain Reprocessing Therapy (PRT) is a psychological treatment that helps people see their pain as a signal the brain can turn down, and teaches them how to do it. In a trial from the University of Colorado Boulder, two thirds of the people who received it finished pain free or nearly pain free.
- Pain free or nearly pain freePain free or nearly pain free
- 66%
- Experienced a reduction in painExperienced a reduction in pain
- 98%
- Improvements persistedThe improvements persisted
- 1 yr+
The 98% figure comes from the Pain Reprocessing Therapy Center, based on the Boulder trial.
Planned release: March 2027
The guide to get out of chronic pain
A guide to understanding nociplastic pain and applying Pain Reprocessing Therapy.
Could your pain be nociplastic?The test
Could your pain be nociplastic?
Nociplastic pain can feel exactly like pain caused by an injury. To understand whether it could be playing a role in your pain, we therefore need to look for certain clues in your history and in the way your pain changes over time.
Answer a few questions to see whether your pain shows some of these clues. This test is not a diagnosis and does not replace medical advice.
The science behind the new model of painThe evidence
The science behind the new model of pain
Papers and trials behind the idea that pain is shaped by the nervous system, not only by tissue damage.
Key papers
- 2011Central sensitization: implications for the diagnosis and treatment of painReview
- 2013Shape shifting pain: chronification of back pain shifts brain representationImaging
- 2019Chronic pain as a symptom or a disease: the IASP classificationConsensus
- 2021Chronic nociplastic pain affecting the musculoskeletal systemConsensus
- 2022Pain Reprocessing Therapy vs placebo and usual care for chronic back painRCT
Our mission
Changing how healthcare treats chronic pain
Pain science has moved on, but care often has not. Our mission is to make sure people living with chronic pain can find a diagnosis that fits and a treatment that works, so that more of them can get out of pain.
Educate
Share the latest advances in pain science
Train
Help clinicians treat nociplastic pain
Connect
Help people find care that fits