Brain-Centered Interventions for Nociplastic Pain: From Symptom Management to Pain Resolution
摘要
Nociplastic pain, recognized as a distinct mechanistic category, arises from altered central nervous system processing rather than peripheral tissue damage. This review synthesizes evidence on contemporary brain‑centered interventions that move beyond symptom management toward potential pain resolution.
Recent FindingsTreatments such as Pain Neuroscience Education, Pain Reprocessing Therapy, Emotional Awareness and Expression Therapy, and Graded Exposure target mechanisms including central sensitization, maladaptive predictive coding, trauma‑related emotional suppression, and learned fear‑avoidance patterns. Data demonstrate that modifying pain‑related threat appraisals, enhancing emotional processing, and facilitating safety learning can produce substantial and sustained pain reduction in selected patients.
SummaryWhile promising, these approaches face challenges related to patient selection, treatment framing, practitioner training, and limited incorporation of objective functional outcomes. Future research should refine mechanistic profiling, identify optimal treatment matching, and strengthen evidence through independent replication.