Pain By Any Other Name

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IASP Definition of Pain

An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.

Definitions You Might Have Seen

Pain is ...

Perception, not sensation.

Created by the brain

Produced by the brain as a response to perception of threat.

A protective output.

A learned behaviour, and can be unlearned.

A warning system.


What one to use and why?

The best place to start is with consensus. The IASP is a non-profit organization that's been running for 50 year and brings together some of the most current (and often contradictory) research on pain mechanisms and management. The definition was developed in 1979 and only very recently and slightly updated after much debate and membership input. Is it perfect? Perhaps not, but it is what we have right now that enables a shared understanding of the meaning of the word pain - in a clinical sense.

The other definitions come from for-profit organizations that develop and market books and courses to the likes of us. The variety of definitions they offer have come about over the last 20 years.

Using the IASP definitions provides a few benefits.

  • The understanding can be shared, which means when we discuss pain with each other there is no confusion.
  • There is no chance of disbelieving your patient because sensation is understood.
  • Treatment can be more realistically delineated between treatments for pain, and treatments for the person.
  • Research that uses this definition will be less confusing in meaning, even if the terminology is used incorrectly.
  • You are less likely to be drawn in by newer, unproven trends in pain care.

You Might Take Note

That the other definitions are more familiar to you. You've heard them before, many times and they've infiltrated almost all levels of pain care. It seems almost like pain as a biopsychosocial output of the brain in response to danger that can be turned up and down or learned and unlearned IS pain care. Pretty impressive market infiltration for perspectives on pain that are so new.

In light of that, take a moment to assess your own understanding of how you define pain and why.

  • Does it align with the other definitions?
  • How would it change if you put sensation first?
  • What would clinical reasoning, patient conversations, and treatment options look like if you reconsider the definition you use?

  1. Penny Sawell
    | Reply

    Thanks Monica, this is useful

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