Review Multimorbidity in Chronic Overlapping Pain Conditions: From Burden to Integrated Care 2026 d'Incau et al

[Andy]

Abstract​

Chronic overlapping pain conditions (COPCs) refer to a set of chronic pain disorders that frequently co-occur and may involve partially overlapping mechanisms. The U.S. National Institutes of Health currently recognizes ten COPCs: fibromyalgia, painful temporomandibular disorders, chronic low back pain, chronic migraine headache, chronic tension-type headache, irritable bowel syndrome, endometriosis, interstitial cystitis/bladder pain syndrome, vulvodynia, and myalgic encephalomyelitis/chronic fatigue syndrome. When multiple COPCs coexist, they are associated with a disproportionate multimorbidity burden, including greater pain, poorer psychological well-being, functional limitations, disability, fatigue, sleep disturbances, diminished quality of life, and increased healthcare utilization. Despite their impact, COPCs remain under-recognized, underdiagnosed, and undertreated.

Combining structured literature searches and citation tracking with narrative syntheses, this review examines comorbid relationships, the burden of multimorbidity, and potentially overlapping nociplastic mechanisms. By adopting a multimorbidity-based perspective rather than a one-disease, one-treatment approach, it highlights barriers to care—including limited clinical awareness, under-recognition of additional COPCs, limited mechanistic understanding, and fragmented care—and proposes integrated strategies emphasizing prevention, systematic screening, mechanism-informed assessment, and coordinated, patient-centered multimodal management.

Open access

 

[Sean]

Buzzword city.

and potentially overlapping nociplastic mechanisms.​

There is the core bit they were building up to.

 

[rvallee]

rather than a one-disease, one-treatment approach

Which is not really a thing, so that's an odd argument to make, but also when you do have one treatment that is very effective on one disease obviously this is an ideal case, something to seek, even target, and you use the hell out of it. Something being effective is not something to bizarrely use as an argument when you haven't done the work to achieve it elsewhere. I'm not sure if by "one disease" they adopt the bizarre belief that lots of physicians ave that the human body must max out at one disease at a time, still it's an oddly popular belief, despite being obviously wrong.

barriers to care—including limited clinical awareness, under-recognition of additional COPCs, limited mechanistic understanding, and fragmented care

That's a lot of similar ways to say the same thing: ya'll got a lot of work to do, and aren't doing it, hence the total lack of progress, which is intentional stagnation while you barely fiddle with the same word combinations. Especially since they already said it in plain language shortly before:

Despite their impact, COPCs remain under-recognized, underdiagnosed, and undertreated

There is more than enough power to the data underlying this to assert a strong cause-and-effect here, but it's so much easier to just continue failing, since there is clearly zero pressure from anywhere to even attempt at improving outcomes.

proposes integrated strategies emphasizing prevention, systematic screening, mechanism-informed assessment, and coordinated, patient-centered multimodal management

Holy marketing department buzzwords collection, Batman. Words that say little and mean even less.

Also, not an especially impressive research effort considering how it's so common in ME/CFS that it's often listed in the criteria:

IBS commonly coexists with FM [6,8,9], cMHA [19], ENDO [21,22], and painful TMDs [8,10,16].

Weirdly enough they note the association in the ME/CFS section:

ME/CFS also frequently co-occurs with other COPCs, including ENDO [24], cMHA, cLBP, IBS, and painful TMDs [89].

So there's a bidirectional relation one way, but not the other. This ideology is so damn weird and nonsensical.

Stagnation is the operative word here. This is complete stagnation, and it's celebrated. Very biopsychosocial.

 

[ahimsa]

ME Research UK wrote an article about this study:

'Chronic overlapping pain conditions’, including ME/CFS, require ‘patient-centred’ care that brings different specialties together.

‘Chronic overlapping pain conditions’, including ME/CFS, require ‘patient-centred’ care that brings different specialties together.

Many people with ME/CFS also live with other illnesses, such as fibromyalgia, irritable bowel syndrome (IBS), chronic migraine, endometriosis, or painful temporomandibular disorders. Because of this, a recent review study by Prof. Emmanuel d’Incau and colleagues is highly relevant. Their...

www.meresearch.org.uk

Many people with ME/CFS also live with other illnesses, such as fibromyalgia, irritable bowel syndrome (IBS), chronic migraine, endometriosis, or painful temporomandibular disorders.

Because of this, a recent review study by Prof. Emmanuel d’Incau and colleagues is highly relevant. Their research reviewed the evidence surrounding what they termed “Chronic overlapping pain conditions” (COPCs)—defined as a “set of overlapping pain conditions that frequently co-occur and may involve partially overlapping mechanisms.”

Unsurprisingly, the review highlighted that where two or more COPCs co-exist in one individual, they create a heavier burden for the person, often resulting in increased pain, reduced functional capacity (the ability to carry out daily activities), diminished quality of life, fatigue, and sleep disturbances.

 

[shak8]

Good for researchers for these conditions to read each others' work and possibly find shared mechanisms. Why not just say that and let the rest of it go.