One of the biggest barriers affecting people live with chronic pain is not being taken seriously or believed – particularly if the pain has an invisible cause.
This barrier can result in lack of proper medical care and understanding among friends, coworkers and even family members.
In 1979, the International Association for the Study of Pain (IASP) defined pain as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”
While this definition may have described acute pain, such pain from a broken ankle, surgery, or an infection, it doesn’t cover the many types of chronic pain experienced by over 50 million adults in the United States.
Now, 41 years later, the IASP has issued a new pain definition: “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
The revised definition is close to the original, but with an important difference.
It acknowledges that chronic or ongoing pain may not cause tissue damage at all, yet the pain continues.
“We hope that the revised definition and accompanying notes will be useful in increasing patients’ and healthcare providers’ understanding of pain as a sensory and emotional experience that may or may not be associated with tissue damage,” Judith A. Turner, PhD, a professor at the University of Washington, in Seattle, told Medical Daily.
“If this understanding is shared by patients and their providers, patient-provider communication and agreement on optimal treatment can be improved.”
It’s important for people living with pain, she said, along with their family and their healthcare providers to all understand that pain can result from factors other than tissue damage, which is what the original definition said.
“Pain is just as “real” as the pain caused by tissue damage. [It] is influenced by biological and psychosocial factors, and these influences need to be assessed and targeted by treatment.”
This revised definition also aims to help the patient discuss pain issues. “The task force hopes that the revised definition will encourage the person in pain to convey a more complete picture of the adverse effects of their pain to their care providers,” Srinivasa N. Raja, MD, explained to Medical Daily.
Raja is Chair of the IASP Task Force and Director of Pain Research, Professor of Anesthesiology & Critical Care Medicine, Professor of Neurology, Johns Hopkins University School of Medicine.
“Similarly, we anticipate that the revised definition may lead the clinicians to not only listen to the patient’s complaints of pain, but also to enquire how the individual’s pain interferes with their daily activities, quality of life, relationships, and social interactions. This information will help develop a personalized, multi-disciplinary, patient centered pain management strategy.”
There had been some criticisms of the 1979 IASP definition because it ignored the many ways the mind and body interact and that the definition neglected “the ethical dimensions of pain,” Raja said.
In addition, Raja pointed out that many believed the earlier definition emphasized verbal self-report and excluded non-verbal behaviors in disempowered and neglected populations, such as newborns and the elderly, as well as in animals.”
It [also] did not take into consideration the cognitive and social factors critical to the pain experience. Finally, research in more recent years has indicated that some types of pain may not be associated with tissue injury and may be associated with nervous system dysfunction.”