Objectives: Some patients with chronic pancreatitis (CP) experience nociplastic pain due to central nervous system dysregulation, yet its recognition is limited by the lack of bedside tools. Self-reported body maps are used to assess pain widespreadedness and to differentiate pain mechanisms in chronic pain patients, but their utility in CP is unclear. This study aimed to determine whether pain widespreadedness, measured via a body map, is associated with features of nociplastic pain in CP. Methods: We conducted a cross-sectional analysis of adults with definite CP enrolled in a single-center longitudinal cohort. Pain widespreadedness was assessed using the Michigan Body Map and categorized by the number of painful regions (0-7) and by presence of localized versus widespread (≥3 regions) pain. Clinical features of nociplastic pain were measured using validated psychometric and pain surveys. Group comparisons were performed with multivariable regression models adjusted for demographics, comorbidities, and CP characteristics. Results: Among 110 participants (mean age 54 years, 52% male), 93% reported abdominal pain. Of those with abdominal pain, 64% had widespread pain. Increasing number of painful regions and widespread pain (versus localized) were independently associated with higher pain severity, pain interference and neuropathic pain scores, as well as more fatigue, impaired physical functioning, greater chronic overlapping pain conditions, and poorer physical and mental health. Conclusion: Two-thirds of patients with CP had widespread pain assessed using a body map. This subgroup had more severe symptoms and features of nociplastic pain. This simple tool may facilitate targeted, mechanism-based pain management in CP.
Machicado et al. (Fri,) studied this question.