IASP's Proposed New Definition of Pain Released for Comment

Sly Saint · Aug 31, 2019

International Association for the Study of Pain

Aug 7, 2019
New Proposed Definition of Pain Open for Public Comment

Nearly two years ago, the IASP Council decided to support the creation of a Task Force to review the current definition of pain that has been widely used for a number of years by many diverse groups globally. The IASP Definition of Pain Task Force is ready to release a new proposed definition of pain and accompanying notes. The proposed new definition of pain is the result of careful discussion, review, and participation from all Task Force members in close coordination with the IASP Council.

IASP values inclusion and transparency, which is why the Task Force, with the support of the IASP Council, is seeking public examination and comment of this work. As a member of the pain community, you’re invited to submit written comments on the proposed new definition of pain. Your feedback will help inform further discussions around the finalization of the definition. We also invite you to share this announcement with colleagues, students, healthcare consumers, and other stakeholders.

The comment period will close at 11:59 ET (UTC/GMT -4) on 11 September 2019. Please read our comment guidelines below and note, at present, IASP cannot respond directly to individual comments.

The IASP Task Force will review all comments and provide a summary and final recommendation to the IASP Council in November 2019.

Guidelines:

Only one submission per person

This form is open to any member of the pain community and not restricted to IASP members

You must follow IASP's Public Comment Policy

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Current Definition of Pain:

An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.

Current Accompanying Notes:

The inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment. Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life. Biologists recognize that those stimuli which cause pain are liable to damage tissue. Accordingly, pain is that experience we associate with actual or potential tissue damage. It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience. Experiences which resemble pain but are not unpleasant, e.g., pricking, should not be called pain. Unpleasant abnormal experiences (dysesthesias) may also be pain but are not necessarily so because, subjectively, they may not have the usual sensory qualities of pain. Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons. There is usually no way to distinguish their experience from that due to tissue damage if we take the subjective report. If they regard their experience as pain, and if they report it in the same ways as pain caused by tissue damage, it should be accepted as pain. This definition avoids tying pain to the stimulus. Activity induced in the nociceptor and nociceptive pathways by a noxious stimulus is not pain, which is always a psychological state, even though we may well appreciate that pain most often has a proximate physical cause.
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Proposed New Definition of Pain:

An aversive sensory and emotional experience typically caused by, or resembling that caused by, actual or potential tissue injury.

Proposed Accompanying Notes Section:

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 behaviors to express pain; inability to communicate does not negate the possibility that a human or a non-human animal experiences pain.

Etymology: Middle English, from Anglo-French peine, from Latin poena (penalty, punishment), in turn from Greek poinē (payment, penalty, recompense).

Submit your comments here by 11:59 ET (UTC/GMT -4) on 11 September 2019.
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seems to be an intended explicit move to bPS model of pain.
https://www.iasp-pain.org/PublicationsNews/NewsDetail.aspx?ItemNumber=9218&navItemNumber=643

eta:
the survey for submission of comments is here:
https://www.surveymonkey.com/r/definitionofpain

Trish · Aug 29, 2019

Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons...
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An unpleasant sensory and emotional experience
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I can't help thinking this was written by men, and possibly women who have not experienced bad period pains. They are a fact of life that most women simply accept and learn to live with, and resort to pain killers when it becomes too difficult to function without, which may or may not be sufficient to enable getting on with life pretending not to be in significant pain.

The pain is not an 'emotional' experience. In fact I found it less 'emotional' than the black fog of depression I used to descend into for a few days premenstrually each month. Though I guess it did become 'emotional' for me on bad days if you count the anxiety that I might pass out from intense pain which I did a few times. I would compare it with the level of pain when I broke a bone.

My ME pain feels like period pains in all my muscles. It's relentless, but it bears no relation to my emotions -neither caused by nor causing except being bloody annoying when it disrupts my concentration or sleep. I can't see how therapy would make any difference to pain apart from persuading people that it's not acceptable to admit to being in pain.

Edited to add quotes.

Jonathan Edwards · Aug 29, 2019

An aversive sensory and emotional experience typically caused by, or resembling that caused by, actual or potential tissue injury.

Seems hopeless. That definition would include being frightened by seeing a bee on your arm or nausea or ringing in the ears or goodness knows what.

NelliePledge · Aug 29, 2019

When they get the all over aching pain of a flu type virus are they having an emotional experience?

rvallee · Aug 29, 2019

NelliePledge said: ↑

When they get the all over aching pain of a flu type virus are they having an emotional experience?
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I'm still curious how those people explain ordinary headaches.

What's the tissue damage there? Anyone? Bueller?

There's probably quite a lot of actual hand-waving accompanying that explanation.

TiredSam · Aug 30, 2019

... typically caused by, or resembling that caused by ...
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I think I can see what they are trying to do there.

Sly Saint · Aug 30, 2019

rvallee said: ↑

I'm still curious how those people explain ordinary headaches.
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@ScottTriGuy recently used a phrase that I think describes a bad migraine to perfection (certainly from my experience).

"a 'kill me now' migraine" ;

nothing to do with emotion, just pure desperation at wanting the pain to stop.

Sean · Sep 1, 2019

Enough rhetorical wiggle room there through which to sail a fleet of aircraft carriers.

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IASP's Proposed New Definition of Pain Released for Comment

Sly Saint Senior Member (Voting Rights)

Trish Moderator Staff Member

Jonathan Edwards Senior Member (Voting Rights)

NelliePledge Moderator Staff Member

rvallee Senior Member (Voting Rights)

TiredSam Committee Member

Sly Saint Senior Member (Voting Rights)

Sean Moderator Staff Member

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IASP's Proposed New Definition of Pain Released for Comment

Sly Saint Senior Member (Voting Rights)

Trish Moderator Staff Member

Jonathan Edwards Senior Member (Voting Rights)

NelliePledge Moderator Staff Member

rvallee Senior Member (Voting Rights)

TiredSam Committee Member

Sly Saint Senior Member (Voting Rights)

Sean Moderator Staff Member

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