The medico-legal pertinence of musculoskeletal nociplastic pain.

Pain conditions can be challenging; nociplastic pain, defined as pain that cannot be sufficiently explained by structural/anatomical changes, is newly categorised as the third pain mechanism. Nociplastic pain complaints are subjective, often accompanied by symptoms of fatigue, sleep and mood disturbance and cognitive difficulties with no diagnostic biomarker or reliable measurement of severity. Medico-legal challenges include attribution of causation after an alleged triggering event, assessment of severity, and reported functional impairment. This review considers nociplastic pain in regard to the musculoskeletal system with focus on causation and temporality of the pain condition and impairment. We hope that this overview will provide a better understanding of these challenging pain conditions.