top of page
  • robinapark

Conceptual basis of pain medicine

Updated: Jan 25, 2021




1-3 Describe how these factors influence patient experience of pain:

Social, Cultural, Psychological, Personality, Physical, Genetic


1-4 Describe medicine’s acceptance of Cartesian dualism and its limitation


1-5 Describe the ICD-11 taxonomy of chronic pain


1-6 Discuss the distinction between nociception and pain


1-7 Compare and contrast the concepts of acute and chronic pain


1-8 Compare and contrast cancer pain and chronic non-cancer pain


1-9 Define and discuss: 􏰀 Placebo, Nocebo, Placebo response, Placebo effect

 

1-1 - 2019 IASP Definition of pain:


2019: An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage"


1978: An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage


  • Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors.

  • Pain and nociception are different phenomena. Pain cannot be inferred solely from activity in sensory neurons.

  • Through their life experiences, individuals learn the concept of pain.

  • A person’s report of an experience as pain should be respected.

  • Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being.

  • Verbal description is only one of several behaviors to express pain; inability to communicate does not negate the possibility that a human or a nonhuman animal experiences pain

Rob's take:

The definition was debated because:


1. It needed to be clear that pain is likely a disease in its own right

2. It did not include discussions of more complex ethical issues or variability for different groups e.g. the elderly or very young

3. The word 'unpleasant' does not involve the complex range of experiences that a person in 'pain' may feel


The definition needed to be:

  1. Valid for acute, chronic and all types of pain regardless of pathophysiology

  2. Applicable to humans and non-humans

  3. Described from the position of the person experiencing the pain, not the observer

The change did what?

'In the old definition, the word “described” in the phrase “or described in terms of such damage” seemed to imply that verbal communication (what, after all, is a “description” other than verbal communication?) was required for pain to exist.'


This is no longer the consensus of the scientific and clinical pain communities, which have agreed now for some time that non-verbal organisms (eg, babies, adults with dementia) are perfectly capable of experiencing pain.


The new definition’s wording – “or resembling that associated with…” – does not require any verbal description. It also places the onus for perceiving pain on the experiencer of that pain, whereas in the old definition, part of that responsibility would lie with whomever heard the description. This change too is in keeping with current best practices regarding believing pain patients when they assert that they’re in pain.


"... [further change to the notes sections included] ...deletion of the sentence in the previous Notes that stated: “pain in the absence of tissue damage or any likely pathophysiological cause” was usually due to psychological reasons."



 

1-2 Discuss the sociopsychobiomedical framework of pain medicine:


1-3 Describe how these factors influence patient experience of pain:

Social, Cultural, Psychological, Personality, Physical, Genetic


1-4 Describe medicine’s acceptance of Cartesian dualism and its limitation


1-5 Describe the ICD-11 taxonomy of chronic pain


1-6 Discuss the distinction between nociception and pain


1-7 Compare and contrast the concepts of acute and chronic pain


1-8 Compare and contrast cancer pain and chronic non-cancer pain


1-9 Define and discuss: 􏰀 Placebo, Nocebo, Placebo response, Placebo effect


51 views0 comments

Recent Posts

See All

Comments


bottom of page