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0:00
Hello, my name is Steven Cohen.
Today, I'm going to talk
about nociplastic pain.
I'm the Edmond I Eger
Professor of Anesthesiology,
Neurology, Physical Medicine
and Rehabilitation,
Psychiatry and
Neurological Surgery at
the Northwestern University
Feinberg School of Medicine,
and a professor at the
Uniformed Services
University of the
Health Sciences
Walter Reed National
Military Medical Center
in Bethesda, Maryland.
0:31
At the end of this talk, the
audience should be able to
identify patients and conditions
associated with
nociplastic pain,
be familiar with the
mechanisms underlying
nociplastic conditions and
why it's important
to identify it,
understand the effect
that nociplastic pain has
on pain treatment
outcomes, and be able to
improve decision-making when
faced with individuals who
have nociplastic pain or
suspected central sensitization.
1:02
These are my disclosures.
There's nothing that's
relevant to this talk.
1:08
It's long been recognized that
there are different
types of pain.
Nociceptive pain is the
most common type of pain.
It encompasses arthritis and
most forms of back
and neck pain.
It results from activity
in neural pathways
secondary to actual or potential
tissue-damaging stimuli.
But it's long been recognized,
for at least 250 years,
that there's another type
of pain, neuropathic pain.
Although John Fothergill,
over 250 years ago,
is often credited with
discovering this concept,
the term probably originated
much further back.
For example, over 1000
years ago, Haly Abbas,
the Persian scholar,
described nerve pain as
like bugs moving, or ants,
or penetrating needles
felt in one's organ
with deficits in
sensation and motor dysfunction
similar to what happens when
your foot falls asleep.
The main difference between
neuropathic and nociceptive pain
is the absence of transduction.
With neuropathic pain,
nerves are directly
stimulated, and it
has a poor prognosis.
Between eight and
probably one-quarter
of people with nerve injury have
persistent pain afterwards.
With major disruption
to major nerves,
it's probably even much higher.
Between 15-25% of chronic pain
is considered to be
primarily neuropathic.
But we now know that
many conditions,
probably most conditions,
have a mixed pain phenotype.
