The old IASP definition of pain as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage” was recommended nearly 40 years ago in 1979.
When IASP began consulting on the proposed new definition, Painaustralia reached out through our networks. We heard back from many consumers, who were understandably very concerned about the definition, with many pointing out several of the widely held criticisms: explicit association of pain with tissue damage and an over-emphasis on the observer’s perspective of pain.
Painaustralia’s own submission to the IASP was supportive of the intention of the IASP to clarify the definition of pain. In particular, we strongly supported the clear link to biological, psychological, and social factors as included in the accompanying notes.
The revised new definition is now "an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage". The revised IASP definition also includes six notes and the etymology of the word "pain" for context.
While on a quick glance the change in the definition of pain and accompanying notes might seem minor, these changes are important. One of the revised notes specifically notes that 'A person's report of an experience as pain should be respected.' This understanding is crucial to patient engagement in pain management, and if overlooked can have many unfortunate consequences, as we have heard through consumer reports of having pain dismissed.
The new definition and its accompanying notes will also be very important in the international context of pain management. Like the old definition, the new one will become accepted widely by health care professionals and researchers in the pain field and adopted by several professional, government, and nongovernment organisations, including the World Health Organization.
New international research has now also flagged the potential for a significant increase in chronic pain after the COVID-19 pandemic. Now more than ever, we must recognise the importance of working together across the globe to tackle the international public health challenge of chronic pain.
If COVID-19 has taught us anything, it should be that health policy must be a continuous process of quality improvement and we must look to other countries to learn from their experiences and improve our own.
In the Australian context implementing Australia’s own Action Plan would go a long way towards ensuring we can respond to increased demand for appropriate responses to chronic pain post pandemic. Lets hope that Australia’s government’s can look beyond medication regulation to more sophisticated ways of supporting Australians living with chronic pain conditions.