Edited by Archita Rai
Medscape Medical News
TOPLINE:
Researchers used a self-reported electronic body map and found that 64% of patients with chronic pancreatitis who reported abdominal pain had widespread pain, and this pain was linked to severe pain symptoms, increased fatigue, poor physical function, and other features of nociplastic pain.
METHODOLOGY:
- Nociplastic pain — characterized by dysregulation of the central nervous system rather than local tissue injury — is recognized as a contributor to refractory pain in chronic pancreatitis, but clinicians lack simple bedside tools to recognize its features.
- Researchers conducted a cross-sectional analysis to determine whether widespread pain on a self-reported body map was associated with clinical features of nociplastic pain in patients with chronic pancreatitis.
- The analysis included adults aged 18-75 years with chronic pancreatitis who were enrolled at a single tertiary center in Michigan between June 2024 and July 2025, all of whom completed baseline electronic questionnaires.
- Pain widespreadness was assessed using the Michigan Body Map by counting painful regions across seven body areas, with localized pain defined as pain in the abdomen only or abdominal pain along with pain in one other region and widespread pain as pain in the abdomen and at least two other regions.
- Clinical features of nociplastic pain were measured using psychometric surveys including the Patient-Reported Outcomes Measurement Information System (PROMIS) 29+2 Profile version 2.1 for symptoms and physical function, the Comprehensive Pain Assessment Tool Short Form (COMPAT-SF) for pancreatitis pain, the painDETECT questionnaire for neuropathic signs, the Pain Catastrophizing Scale, and a screener for other chronic overlapping pain conditions.
TAKEAWAY:
- The analysis included 110 patients (mean age, 53.7 years; 52% men). A total of 102 (93%) reported abdominal pain, of whom 64% had widespread pain.
- An increasing number of painful regions was independently associated with reduced physical function (P = .03), increased fatigue (P = .002), greater pain interference (P = .01), higher anxiety level (P = .04), a reduced PROMIS Preference Score (P = .02), worse mental health (P = .01), and impaired physical health (P < .001); several pain-related scores were also increased.
- Among patients with abdominal pain, those with widespread vs localized pain had higher COMPAT‑SF subscores for pain severity, spreading, qualitative pain, and total pain; higher painDETECT scores; and more chronic overlapping pain conditions (P < .05 for all).
- Sleep disturbance, anxiety, depression, pain catastrophizing, and childhood trauma were not associated with widespread pain in a multivariable analysis.
IN PRACTICE:
“A simple body map enables clinicians to differentiate between widespread and localized pain subgroups in CP [chronic pancreatitis], which represent distinct phenotypes with different psychometric profiles and pain outcomes. The use of body maps may assist clinicians in distinguishing between pain mechanisms and recognizing nociplastic pain at the bedside,” the authors of the study wrote.
SOURCE:
The study was led by Jorge D. Machicado, MD, MPH, University of Michigan in Ann Arbor, Michigan. It was published online in Clinical and Translational Gastroenterology.
LIMITATIONS:
The study was conducted at a single center with mostly White patients, which limited generalizability. The cross‑sectional study design prevented determination of causality or whether nociplastic features preceded widespread pain. Researchers relied on electronic self‑reports and lacked COMPAT‑SF data for 12 participants.