Nociplastic Questionnaire (NociQ)

OBJECTIVES: Nociplastic pain is implicated in many chronic pain conditions, yet it has been defined primarily by the absence of structural causes-a diagnosis by exclusion. No validated nociplastic pain questionnaire exists. This study examined hypothesized pain-specific features of nociplastic pain and developed a brief self-report instrument, the Nociplastic Questionnaire (NociQ). METHODS: We generated items based on literature review and input from experts and individuals with lived experience. We administered the items and measures of other pain-related constructs (pain intensity/interference, catastrophizing, kinesiophobia, and perceived stress) to 888 participants with diverse chronic pain conditions. RESULTS: Factor analyses supported four dimensions captured by internally consistent 4-item subscales (αs ≥0.74): 1) location variability, 2) exacerbation by thoughts and emotions, 3) widespreadness, and 4) allodynia. The NociQ total score adequately discriminated presumed nociplastic and non-nociplastic conditions (AUCs 0.73-0.75). Participants who had widespread pain or reported more presumed nociplastic conditions scored higher on all scales (ps <.001, ds=0.35-1.37). NociQ scales demonstrated small-to-moderate correlations with measures of theoretically distinct constructs (rs=0.10-0.44), supporting discriminant validity, and explained additional variance in pain intensity beyond those measures (ΔR²s=.02-.07; ps <.05), supporting incremental validity. DISCUSSION: Results indicate four nociplastic pain characteristics, including two, location variability and exacerbation by thoughts and emotions, psychometrically validated here for the first time. The 16-item NociQ demonstrates promising reliability and validity as a brief questionnaire of nociplastic pain. Future research should examine its clinical utility, such as in matching patients to pain mechanism-targeted treatments.