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These persisting pain states under adequate treatment, without any sign of inflammation, led researchers to look for evidence of central sensitization states. In these conditions, even with very active biological treatment, almost a third of patients are still complaining of persisting pain. the concept of central sensitization in inflammatory rheumatic diseases is increasingly discussed. In this new classification, one can differentiate primary musculoskeletal pain including fibromyalgia and low back pain and secondary musculoskeletal pain related to specific etiologies. the latest International Classification of Diseases (ICD-11) includes an IASP task force that developed a new classification system for pain. the new pain taxonomy recently has been modified with a third descriptor with the concept of nociplastic pain.
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