Recently the International Association for the Study of Pain (IASP)s proposed a new definition of pain for consultation.
The IASP works to support research, education, clinical treatment, and better patient outcomes for all pain conditions with the goal of improving pain relief worldwide.
With more than 7,000 members representing 125 countries, 96 national chapters, and 24 Special Interest Groups (SIGs), IASP fosters the exchange of ideas and education to advance the field of pain science. IASP also publishes two journals: PAIN, devoted to original research on the nature, mechanisms, and treatment of pain, and PAIN Reports, an online, open access, multidisciplinary journal that advances clinical, applied, and basic research. Suffice to say, that the IASP is an important organisation that is at the forefront of pain management across the globe.
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.
Current Definition of Pain:
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
In August, the IASP Definition of Pain Task Force released a new proposed definition of pain and accompanying notes. Criticisms of the IASP definition (which was approved in 1979) include the explicit association of pain with tissue damage, perpetuation of dualistic body–mind thinking and unresolved tension between the primacy of self-report and the privileging of the perspective of the observer.[i]
Historically, pain has been considered as a “symptom of something” — a symptom to be alleviated in the short term while a diagnosis is pursued, or a cure sought for the underlying disease. Researchers now understand that pain may persist beyond the time it takes for damaged tissues to heal, altering the central nervous system in such a way that chronic pain is justifiably classified as a disease in its own right.
Proposed New Definition of Pain:
An aversive sensory and emotional experience typically caused by, or resembling that caused by, actual or potential tissue injury.
The proposed new definition helps to remove the presumption and primarily biomedical association of pain with injury. Accompanying notes also go a step further in explicitly outlining the bio-psycho-social impact of pain.
Painaustralia is supportive of the intention of the IASP to clarify the definition of pain. In particular, we strongly support the clear link to biological, psychological, and social factors as included in the accompanying notes.
The bio-psycho-social approach often means that more than one category of health professionals will be required to make a full assessment and to communicate with each other to weigh up the relative contributions, enabling selection of the most appropriate treatment or treatments in an interdisciplinary approach.
Our submission also notes that accumulating evidence from a range of sources, both in Australia and internationally that points to major shortcomings in the ways in which pain is addressed.
There is currently a major focus on moving away from prescribing medication as the first line approach to management. It is important to recognise and ensure that this must not come at the cost of worse outcomes for people living with chronic pain.
This is why we recommend that along with updating the definition of pain, we must work together to ensure that access to best practice interdisciplinary care becomes a reality for the millions of people living with pain everyday around the globe.