Evidence map›Paper›PMID 40809798›Full record

ReviewPain reports2025

Medical jurisprudence in the context of chronic musculoskeletal nociplastic pain: the clinical medico-legal interface.

Rodrigo Deamo Assis, Nimish Mittal, Hance Clarke, Mary-Ann Fitzcharles

Abstract readReview
In one paragraph

Review in Pain reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. The stigmatization of patients with chronic pain due to assessed exaggeration of symptoms.Canadian journal of pain = Revue canadienne de la douleur · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Rodrigo Deamo AssisCentre Intégré de Santé et Services Sociaux de l'Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada.
Nimish MittalDepartment of Anesthesia and Pain Management, University of Toronto, Toronto, ON, Canada.
Hance ClarkeDepartment of Anesthesia and Pain Management, Pain Research Unit, Toronto General Hospital, Toronto, ON, Canada.
Mary-Ann FitzcharlesDepartment of Rheumatology, McGill University, Montreal, QC, Canada.ORCID https://orcid.org/0000-0002-1091-3175

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic primary musculoskeletal pain is prevalent and often the cause of medico-legal dispute. Pain with an unknown etiology that occurs in the absence of substantial tissue abnormality has challenged the health care community for decades. The World Health Organization now recognizes chronic primary pain (CPP) conditions as valid conditions that are prevalent and a cause of considerable suffering. Without an objective test or biomarker to confirm diagnosis or measure severity, CPP conditions may be brought before the Court with questions of severity, causation, functional impairment, and disablement. The many subjective symptoms that associate with CPP pain add to the total burden of illness and also to the complexity of the adjudication process. This review will discuss the responsibilities of clinicians when providing an opinion to aid a legal adjudication process. Medical information regarding CPP should be objectively and clearly stated, without bias and must remain within the practice domain of the clinician. The distinct roles of the treating clinician and the medico-legal expert will be compared. Issues concerning assessment of severity, validity measures to assess subjective symptoms, matters of causation, and impact on function are discussed. Irrespective of the legal setting, whether a regional tribunal or higher national court, the health care professional providing testimony must adhere to the highest ethical standards. Understanding the medico-legal process that functions in parallel, but differently from clinical care, will prepare health care professionals to provide relevant information that will lead to a fair and just outcome for those truly suffering with chronic pain.

Indexed as

Medico-legalPrimary musculoskeletal pain

Identifiers

PMID40809798
PMCPMC12348395

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.