Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations

Jo Nijs*, Eva Kosek, Alessandro Chiarotto, Chad Cook, Lieven A Danneels, César Fernández-de-Las-Peñas, Paul W Hodges, Bart Koes, Adriaan Louw, Raymond Ostelo, Gwendolyne G M Scholten-Peeters, Michele Sterling, Othman Alkassabi, Hana Alsobayel, Darren Beales, Paraskevi Bilika, Jacqui R Clark, Liesbet De Baets, Christophe Demoulin, Rutger M J de ZoeteÖmer Elma, Annelie Gutke, Rikard Hanafi, Sabina Hotz Boendermaker, Eva Huysmans, Eleni Kapreli, Mari Lundberg, Anneleen Malfliet, Ney Meziat Filho, Felipe J J Reis, Lennard Voogt, Kory Zimney, Rob Smeets, Bart Morlion, Kurt de Vlam, Steven Z George

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

1 Citation (Scopus)


The potential to classify low back pain as being characterised by dominant nociceptive, neuropathic, or nociplastic mechanisms is a clinically relevant issue. Preliminary evidence suggests that these low back pain phenotypes might respond differently to treatments; however, more research must be done before making specific recommendations. Accordingly, the low back pain phenotyping (BACPAP) consortium was established as a group of 36 clinicians and researchers from 13 countries (five continents) and 29 institutions, to apply a modified Nominal Group Technique methodology to develop international and multidisciplinary consensus recommendations to provide guidance for identifying the dominant pain phenotype in patients with low back pain, and potentially adapt pain management strategies. The BACPAP consortium's recommendations are also intended to provide direction for future clinical research by building on the established clinical criteria for neuropathic and nociplastic pain. The BACPAP consortium's consensus recommendations are a necessary early step in the process to determine if personalised pain medicine based on pain phenotypes is feasible for low back pain management. Therefore, these recommendations are not ready to be implemented in clinical practice until additional evidence is generated that is specific to these low back pain phenotypes.

Original languageEnglish
Pages (from-to)e178-e188
JournalThe Lancet Rheumatology
Issue number3
Early online date1 Feb 2024
Publication statusPublished - Mar 2024

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© 2024 Elsevier Ltd


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