Conditions

Pain Redefined to Be More Inclusive

pain
Pain means different things to different people, but the medical community has refined its definition. Photo courtesy of Shutterstock.

Ask anyone what pain is and you’ll likely get a response like, “an unpleasant sensation” or “a sensation that causes suffering.” And they’d be right. But the medical community constantly re-evaluates how it defines medical conditions to ensure they are as accurate as possible. This year, the word "pain" was tweaked.

In 1979, pain was defined by the International Association for the Study of Pain as, “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Now, in 2020, the definition has been changed, albeit subtly: “An unpleasant sensory experience associated with, or resembling that associated with, actual or potential tissue damage.”

What’s the difference? The first definition focused on acute pain or chronic pain that had an obvious cause – a broken leg, a herniated disk, an infected wound. But it didn’t address pain that doesn’t have an obvious cause, like fibromyalgia or phantom limb pain.

Another difference is that the 1979 definition mentions how pain is described. But not everyone can describe pain. They may be non-verbal or have dementia, for example. While this difference may seem insignificant, it isn’t. "Changing this language enables physicians to adequately account for pain in disempowered and neglected populations such as children, the elderly and people with disabilities," said Srinivasa Raja, M.B.B.S., in a press release. Dr. Raja is a professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine and chair of the IASP task force that created the revised description.

"When pain affects peoples' function, psyche and their social well-being, it needs to be recognized by insurance carriers that dictate who gets care and what aspects of their multidisciplinary care are reimbursed," added Dr. Raja.

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