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<p>Pain is a&#xa0;complex and individually experienced phenomenon that is influenced not only by biological but also strongly by psychosocial factors. In addition to nociceptive and neuropathic pain, nociplastic pain has been introduced as a&#xa0;third category, characterized by altered central pain processing in the absence of clear tissue or nerve damage. This type of pain is particularly associated with diffuse symptoms besides pain as well as with psychosocial burden. The development of nociplastic pain is multifactorial and includes not only genetic and hormonal influences but also psychosocial and life-course factors. Early life stress, trauma, and psychological factors such as anxiety and catastrophizing play a&#xa0;key role. At the same time, there is a&#xa0;bidirectional relationship between pain and mental health. Neurobiologically, changes can be observed in brain regions involved in pain perception and evaluation. Psychological treatment approaches such as cognitive behavioral therapy, acceptance and commitment therapy, and perioperative interventions show overall moderate effects. Pain reprocessing therapy (PRT) is a&#xa0;promising approach that reframes nociplastic pain as a&#xa0;modifiable, non-threatening brain-generated process, thereby enabling substantial and sustained pain relief.</p>

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Schmerz und Psyche

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月24日

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  • Irina Gessl

摘要

Pain is a complex and individually experienced phenomenon that is influenced not only by biological but also strongly by psychosocial factors. In addition to nociceptive and neuropathic pain, nociplastic pain has been introduced as a third category, characterized by altered central pain processing in the absence of clear tissue or nerve damage. This type of pain is particularly associated with diffuse symptoms besides pain as well as with psychosocial burden. The development of nociplastic pain is multifactorial and includes not only genetic and hormonal influences but also psychosocial and life-course factors. Early life stress, trauma, and psychological factors such as anxiety and catastrophizing play a key role. At the same time, there is a bidirectional relationship between pain and mental health. Neurobiologically, changes can be observed in brain regions involved in pain perception and evaluation. Psychological treatment approaches such as cognitive behavioral therapy, acceptance and commitment therapy, and perioperative interventions show overall moderate effects. Pain reprocessing therapy (PRT) is a promising approach that reframes nociplastic pain as a modifiable, non-threatening brain-generated process, thereby enabling substantial and sustained pain relief.