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Papers of the Week

Papers: 2 Feb 2019 - 8 Feb 2019

2019 Sep

J Pain



Congenital Insensitivity to Pain – A Misnomer.


Weisman A, Quintner J, Masharawi Y
J Pain. 2019 Sep; 20(9):1011-1014.
PMID: 30716471.


"Congenital insensitivity to pain (CIP)" is an umbrella term used to describe a group of rare genetic diseases also classified as "Hereditary Sensory Autonomic Neuropathies (HSAN)". These are intriguing conditions with potential to shed light on the poorly understood relationship concerning nociception and the experience of pain. However, the term CIP is epistemologically incorrect and is the product of historical circumstances. The term conflates pain and nociception and thus prevents researchers and caregivers from grasping the full dimensions of these conditions. The aims of this article are to review the epistemological problems surrounding the term, to demonstrate why the term is inaccurate and to suggest a new term: "Congenital Nociceptor Deficiency". The suggested term better reflects the nature of the conditions, and incorporates current understandings of nociception. Perspective: The umbrella term "Congenital Insensitivity to Pain" conflates pain and nociception, which is epistemologically unacceptable. We suggest a new term – Congenital Nociceptor Deficiency – that overcomes this problem and is concordant with current neurobiological knowledge.