11. Raja et al. 2020

Introduction

• Pain: an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

Pro and con arguments for updating the IASP definition

• Although tissue injury is a common antecedent to pain, pain can be present even when tissue damage is not discernible
• Different definitions of pain
• Criticisms:
  • Redundant
  • Outdated
  • Lacks precision

Pain

• Pain: an aversive sensory and emotional experience typically caused by, or resembling that caused by, actual or potential tissue injury

Notes

• Pain is always a subjective experience that is influenced to varying degrees by biological, psychological, and social factors
• Pain and nociception are different phenomena: the experience of pain cannot be reduced to activity in sensory pathways
• Through their life experiences, individuals learn the concept of pain and its applications
• A person’s report of an experience as pain should be accepted as such and respected
• Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being
• Verbal description is only one of several behaviours to express pain; inability to communicate does not negate the possibility that a human or a nonhuman animal experiences pain

Potential benefits of this new definition

• Creation of a chronic pain classification: ICD-11
• A revised definition of pain is very timely and aligns with current efforts to advance ontological frameworks within which pain resides
• We must recognize pain as an important health condition and this will transform pain research and the care of persons with pain worldwide

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