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Chronic pain that does not resolve with structurally directed treatment and does not meaningfully respond to anti-inflammatories is often nociplastic pain driven by central sensitization. In these cases, the original tissue injury may have healed, but the central nervous system continues to generate pain signals independent of ongoing damage. This is not imaginary pain and it is not a character flaw. It is a dysregulated nervous system. For a significant subset of chronic pain patients, unresolv

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