Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
Nociplastic chronic neck pain: From mechanisms to physical therapy clinical practice
Emmanouil Kapernaros, Department of Physiotherapy, University of West Attica, Athens 12243, Attica, Greece
George A Koumantakis, Laboratory of Advanced Physiotherapy, Department of Physiotherapy, University of West Attica, Athens 12243, Attica, Greece
Author contributions: Kapernaros E contributed to performing the majority of the writing; Koumantakis GA contributed to providing supervision and assisted with literature organization; Kapernaros E and Koumantakis GA contributed to conceptualizing and designing the study, developing the research framework; drafted the initial manuscript; and reviewed and approved the final manuscript as submitted.
AI contribution statement: The authors used a generative AI tool (Claude 3.5 Sonnet, Anthropic) as assistive technology during preparation of this manuscript, including for translation from the authors’ original Greek draft, English language refinement and grammar correction. The authors agree to accountability for all content of this manuscript, including any portions for which AI tools were used. All AI-assisted outputs have been carefully reviewed, verified, and validated by the authors, who take full responsibility for the accuracy, integrity, and originality of the manuscript. AI tools were not used to generate data, perform analyses, or draw scientific conclusions.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: George A Koumantakis, Associate Professor, Laboratory of Advanced Physiotherapy, Department of Physiotherapy, University of West Attica, 28 Agiou Spyridonos Street, Athens 12243, Attica, Greece. gkoumantakis@uniwa.gr
Received: April 13, 2026
Revised: June 2, 2026
Accepted: July 2, 2026
Published online: August 18, 2026
Processing time: 125 Days and 17 Hours
Revised: June 2, 2026
Accepted: July 2, 2026
Published online: August 18, 2026
Processing time: 125 Days and 17 Hours
Core Tip
Core Tip: This review integrates the concept of nociplastic pain, a mechanistic pain descriptor recognized by the International Association for the Study of Pain, into the understanding and rehabilitation of chronic neck pain. It encompasses the pathophysiological framework of altered nociception, proposes a clinical reasoning approach based on the predominant pain mechanism, and translates these concepts into rehabilitation principles including patient education, graded exposure, sensorimotor retraining, and functionally targeted exercise. This mechanism-based framework supports individualized clinical decision-making beyond structural explanations and may reduce the risk of misdirected interventions.