IASP's Proposed New Definition of Pain Released for Comment

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

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).


Submit your comments here by 11:59 ET (UTC/GMT -4) on 11 September 2019.


IASP Definition of Pain Task Force

Chair: Srinivasa Raja, MD (USA) 
Dan Carr, MD (USA) 
Milton Cohen, MD (Australia)
Nanna Finnerup, MD (Denmark)
Herta Flor, PhD (Germany) 
Stephen Gibson, PhD (Australia) 
Francis Keefe, PhD (USA) 
Jeffrey Mogil, PhD (Canada) 
Matthias Ringkamp, MD, PhD (USA) 
Kathleen Sluka, PT, PhD (USA)
Xue Jun Song, MD, PhD (China) 
Bonnie Stevens, RN, PhD (Canada)
Mark D. Sullivan, MD, PhD (USA) 
Takahiro Ushida, MD, PhD (Japan)