Is my pain neuroplastic?

What does this screener actually measure?

It measures two independent things that get conflated constantly in chronic pain care — the mechanism producing the pain, and the beliefs shaping what you do about it.

Part 1 — neuroplastic pain features (0–24)

Twelve questions covering the profile clinicians look for when they make a positive diagnosis of neuroplastic pain: pain lasting three months or more, a regional or shifting distribution rather than one precise spot, symptoms not fully explained by imaging, hypersensitivity to things that should not hurt, onset during a stressful period, triggering by anticipation, pain-free windows, and the cluster of centrally-mediated comorbidities — fatigue, poor sleep, brain fog, headaches, gut symptoms.

Part 2 — fear-avoidance beliefs (0–24)

Four statements adapted from the FABQ physical-activity subscale, each rated 0 (completely disagree) to 6 (completely agree). This is not about how much pain you have — it is about how dangerous you believe movement to be. That belief predicts disability and slow recovery better than pain intensity does, and unlike tissue damage, it responds directly to treatment.

How is the score calculated?

Each of the twelve feature questions scores 2 for yes, 1 for somewhat, and 0 for no, giving 0–24. Each of the four fear-avoidance statements scores 0–6, also giving 0–24. Neither score is a percentage of anything and neither is a diagnosis — they are a structured way to see how much of a pattern you fit.

What is the Fear-Avoidance Beliefs Questionnaire (FABQ)?

The FABQ, developed by Waddell and colleagues in 1993, is a 16-item questionnaire measuring how strongly a person believes that physical activity and work will cause harm and should therefore be avoided. Each item is rated 0 (completely disagree) to 6 (completely agree).

• FABQ-PA (physical activity) — items 2, 3, 4 and 5, scored 0–24. A score of 15 or above is generally treated as elevated.
• FABQ-W (work) — items 6, 7, 9, 10, 11, 12 and 15, scored 0–42. Scores above about 34 are associated with poor return-to-work outcomes.
• The remaining items — 1, 8, 13, 14 and 16 — are administered but are not scored.

The full FABQ, including the work subscale and its exact item wording, should be administered and interpreted by a clinician. The four questions in the screener above are adapted from the physical-activity subscale — reworded to cover pain anywhere in the body rather than the back specifically, and scored on the same 0–24 range so the result is interpretable against the familiar threshold.

Fear-avoidance matters because it is a loop, not a trait: believing movement is dangerous leads to avoidance, avoidance leads to deconditioning and to a nervous system that becomes more certain the area needs protecting, and that certainty produces more pain. Breaking the loop is a large part of what pain reprocessing therapy and graded exposure do.

Is there an official neuroplastic pain questionnaire?

Not a single agreed one, no — and that is worth knowing before you go looking for a definitive test. What exists instead is a set of clinical criteria plus several validated questionnaires that measure adjacent constructs.

• The IASP clinical criteria for nociplastic pain (Kosek et al.) — pain of at least three months, a regional rather than discrete distribution, pain not entirely explained by nociceptive or neuropathic mechanisms, and evidence of pain hypersensitivity. With a history of regional hypersensitivity plus comorbidities such as sleep disturbance, fatigue, cognitive problems, or sensitivity to light, sound or smell, the classification becomes probable nociplastic pain.
• The Central Sensitization Inventory (CSI) — a validated 25-item measure of central-sensitivity symptoms, widely used in research and clinics.
• Positive clinical features used by clinicians who diagnose neuroplastic pain — onset in a stressful period, symptoms that move or vary with context, triggering by anticipation, and pain-free windows.

The screener on this page draws on all three, which is why it produces a likelihood band rather than a label. A clinician confirming the diagnosis is still the necessary step.

What should you do with your result?

Take it to a clinician. The most useful thing a screener like this does is change the question you walk in with — from *'why can't anyone find what's wrong?'* to *'could this be nociplastic pain, and if so what treats it?'*

1. Deal with anything flagged in the safety check first — those need assessment, not retraining.
2. Print or save your result and bring the two scores to your next appointment.
3. Ask directly whether a nociplastic or neuroplastic mechanism explains your pain, and what would confirm or rule it out.
4. If fear-avoidance came back elevated, ask specifically about graded exposure — not rest.
5. Learn the mechanism: understanding how pain is produced has itself been shown to reduce it.

If the picture fits, the treatments worth asking about are the ones aimed at the pain system rather than the tissue: pain reprocessing therapy, emotional awareness and expression therapy, pain neuroscience education, graded exposure, and VR embodiment training. Chronic pain treatment options covers how these compare with the tissue-directed approaches.

What can this screener not tell you?

It cannot diagnose. It cannot detect a fracture, an infection, an inflammatory disease, a tumour, or nerve compression — all of which can produce long-standing pain and all of which need medical assessment. It cannot tell you what proportion of your pain is structural. And a low score does not mean your pain is untreatable, any more than a high score means it is imagined.

Used properly, this is a structured way to notice a pattern you may have been living inside for years without a name for it — and then to go and get it checked.