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IASP’s proposed new definition of pain released for comment


August 16, 2019
By Staff

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

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.


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).