Explaining the Definition of Pain

The International Society for the Study of Pain (IASP, its acronym in English) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential damage or described in terms of such damage”.
While official definitions are always too broad and vague, they must be able to represent all aspects of what they describe, there are several points that can be explained in relation to this definition: ( Based on corefitness blog )
1. Unlike a sense, following the transfer of a series of pulses from the nervous system and consciousness of this, the experience involves the processing of such information and preparing a response. Thus, at the same tactile stimulation, we can feel pleasure or disgust, as we touch our partner in caring attitude or lama we both hate that dog.
2. It is clear that there must be a negative emotional and affective component of pain there. The absence of this component, rule out the existence of pain it is outside the official definition of pain.
3. The association to an actual or potential harm tissue is directly related nociceptive activity (normally begins shortly before suffering damage tissues, hence the term “potential damage” from the definition).
4. Dysfunctional pain, which occur in the absence of injury or danger of tissues and are more related to the processing of such information by the nervous system, are reflected in the ultimate expression of the definition: described in terms of such damage

 

The experience of pain is unique. We can come to understand relatively well when nociception predominates and the individual is not subjected to a stressful enough situation to modify the response of individual in relation to that nociceptive input. In this case we felt a pain related to nociception both in location and intensity. However, when we explain what we do differently, we use our own words, based on our experiences and feelings to express that experience.

If we talk about pain when we refer to something complex, it does not have much sense that we do so in terms that tend to over-simplify. Clearly there is a relationship between stimulus and response, tissues and pain, especially in laboratory. In real life, the experience is complicated and clinician must address various aspects of cognitions, social relationships, feelings, coping capacities, perceptions and expectations of recovery … In this perspective, Nathalie Roussel tried to figure out a study to what aspects physiotherapist pays more attention during the clinical interview with the patient: biomedical aspects related to the disease, perception of causality (physical and mechanical aspects) and the ability to control and coping by the patient. However, too much attention to the understanding of pain by the patient was not given the consequences it has on their quality of life, duration and evolution of pain and emotional aspects, although in many cases the patient provided relevant information spontaneously.

In the study only the initial interview was recorded, so we might assume that these aspects be investigated in a second visit, but would involve starting treatment without sufficient knowledge of the situation in at least some cases: those in which psychosocial factors are truly important and dysfunctional pain related to a pathological central sensitization. While it is a personal impression, I think that complex pains are not addressed properly in many cases because they are not detected. If so, this study could approach the answer: simply not inquire enough about what makes them unique.

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