• Muath A Shraim, Kathleen A Sluka, Michele Sterling, Lars Arendt-Nielsen, Charles Argoff, Karl S Bagraith, Ralf Baron, Helena Brisby, Daniel B Carr, Ruth L Chimenti, Carol A Courtney, Michele Curatolo, Beth D Darnall, Jon J Ford, Thomas Graven-Nielsen, Melissa C Kolski, Eva Kosek, Richard E Liebano, Shannon L Merkle, Romy Parker, ReisFelipe J JFJJPhysical Therapy Department of Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil.Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vri, Keith Smart, SmeetsRob J E MRJEM0000-0002-9503-366Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands.CIR Rehabilitation, Eindhoven, the Netherlands., Peter Svensson, Bronwyn L Thompson, Rolf-Detlef Treede, Takahiro Ushida, Owen D Williamson, and Paul W Hodges.
• The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health & Rehabilitation Sciences, Brisbane, QLD, Australia.
• Pain. 2022 Sep 1; 163 (9): 181218281812-1828.

AbstractClassification of musculoskeletal pain based on underlying pain mechanisms (nociceptive, neuropathic, and nociplastic pain) is challenging. In the absence of a gold standard, verification of features that could aid in discrimination between these mechanisms in clinical practice and research depends on expert consensus. This Delphi expert consensus study aimed to: (1) identify features and assessment findings that are unique to a pain mechanism category or shared between no more than 2 categories and (2) develop a ranked list of candidate features that could potentially discriminate between pain mechanisms. A group of international experts were recruited based on their expertise in the field of pain. The Delphi process involved 2 rounds: round 1 assessed expert opinion on features that are unique to a pain mechanism category or shared between 2 (based on a 40% agreement threshold); and round 2 reviewed features that failed to reach consensus, evaluated additional features, and considered wording changes. Forty-nine international experts representing a wide range of disciplines participated. Consensus was reached for 196 of 292 features presented to the panel (clinical examination-134 features, quantitative sensory testing-34, imaging and diagnostic testing-14, and pain-type questionnaires-14). From the 196 features, consensus was reached for 76 features as unique to nociceptive (17), neuropathic (37), or nociplastic (22) pain mechanisms and 120 features as shared between pairs of pain mechanism categories (78 for neuropathic and nociplastic pain). This consensus study generated a list of potential candidate features that are likely to aid in discrimination between types of musculoskeletal pain.Copyright © 2022 International Association for the Study of Pain.

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