Mechanisms and Management of Chronic Pain: Nociceptive, Neuropathic, and Nociplastic Perspectives

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (1 July 2026) | Viewed by 898

Editor


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Guest Editor
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Madrid, Spain
Interests: headache; chronic pain; physical therapy; rehabilitation; sensitization; mechanisms
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Special Issue Information

Dear Colleagues,

Chronic pain represents a continuous challenge for clinicians and researchers. In recent decades, there have been increasing advances in the mechanisms and management of chronic pain since a better understanding of its mechanisms can lead to personalized-tailored treatments. Due to the heterogeneity clinical presentation of chronic pain conditions, three pain phenotypes, i.e., nociceptive, neuropathic and nociplastic pain, as well as a mixed-type phenotype, were proposed for classification of chronic pain. This classification was originally described for research purposes and has been slightly criticized for its clinical application because of discrimination between these pain phenotypes in clinical practice can be difficult since a patient can fit into more than one pain phenotype, where one type (i.e., neuropathic) does not exclude another phenotype (i.e., nociplastic), or can evolve from one to another phenotype with time. We are pleased to invite you to submit manuscripts to this Special Issue “Mechanisms and Management of Chronic Pain: Nociceptive, Neuropathic, and Nociplastic Perspectives”.

This Special Issue aims to better understand those mechanisms of chronic pain by applying this classification of nociceptive, neuropathic and nociplastic pain phenotypes into specific pain conditions. This Special Issue will focus on mechanisms and treatment aspects of chronic pain and its classification into nociceptive, neuropathic and nociplastic pain phenotypes and the identification of this classification to serve as a potential predictor of personalized-tailored treatment approaches.

We invite researchers/clinicians to submit original articles, systematic reviews, narrative reviews, meta-analysis, cohort and case–control studies related to mechanisms and management of chronic pain.

Prof. Dr. César Fernández-de-las-Peñas
Guest Editor

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Keywords

  • pain
  • nociplastic
  • sensitization
  • neuropathic
  • mechanisms
  • treatment
  • classification

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Published Papers (1 paper)

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Review

30 pages, 1090 KB  
Review
Diagnostic Utility of Surface Electromyography for Identifying Muscles Affected by Myofascial Trigger Points: A Scoping Review
by Jakub Matuska, Ryszard Śliwiński, Jędrzej Pepliński, Wiktoria Frącz, Clara Leśniak, Elżbieta Skorupska and Manel M. Santafé
Biomedicines 2026, 14(6), 1406; https://doi.org/10.3390/biomedicines14061406 - 22 Jun 2026
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Abstract
Background: The diagnostic value of surface electromyography (sEMG) for identifying muscles affected by myofascial trigger points (TrPs) remains controversial. However, advances in pain neurophysiology and discussions regarding TrPs within the International Classification of Diseases (ICD-11) have renewed interest in objective diagnostic approaches. [...] Read more.
Background: The diagnostic value of surface electromyography (sEMG) for identifying muscles affected by myofascial trigger points (TrPs) remains controversial. However, advances in pain neurophysiology and discussions regarding TrPs within the International Classification of Diseases (ICD-11) have renewed interest in objective diagnostic approaches. Objective: To synthesize current evidence on the diagnostic utility of sEMG for detecting TrP-related muscle alterations across different electromyographic signal analysis domains. Methods: A scoping review was conducted following JBI guidance and PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, CINAHL and Cochrane were searched for studies involving adults with symptomatic or asymptomatic TrPs, myofascial pain syndrome, or TrP-related referred pain. Fifteen studies met the inclusion criteria. Analyses included amplitude-, frequency-, time–frequency-, and spatial-domain sEMG parameters. Results: Muscles affected by TrPs showed increased resting electromyographic activity and reduced activation during maximal voluntary contraction in several studies. Frequency domain analyses indicated changes in median frequency and muscle fatigue index, whereas time–frequency analyses suggested redistribution of sEMG signal energy toward lower-frequency components or altered spectral power during experimentally provoked referred pain. Spatial analyses revealed altered activation patterns, although these findings did not consistently correspond with TrP anatomical locations. Overall, the limited number of studies assessing diagnostic sensitivity and specificity prevents firm conclusions. Conclusions: sEMG may be useful as a non-invasive complementary tool for functional assessment and monitoring of TrP-related muscle dysfunction. However, current evidence does not support its use as a standalone diagnostic method. Time–frequency, machine learning-supported and spatial analyses appear promising for future clinical research, but standardized protocols and external validation are required before clinical diagnostic criteria can be proposed. Full article
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