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The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises
Open accessAbstract
The current International Association for the Study of Pain (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 by the Subcommittee on Taxonomy and adopted by the IASP Council in 1979. This definition has become accepted widely by health care professionals and researchers in the pain field and adopted by several professional, governmental, and nongovernmental organizations, including the World Health Organization. In recent years, some in the field have reasoned that advances in our understanding of pain warrant a reevaluation of the definition and have proposed modifications. Therefore, in 2018, the IASP formed a 14-member, multinational Presidential Task Force comprising individuals with broad expertise in clinical and basic science related to pain, to evaluate the current definition and accompanying note and recommend whether they should be retained or changed. This review provides a synopsis of the critical concepts, the analysis of comments from the IASP membership and public, and the committee's final recommendations for revisions to the definition and notes, which were discussed over a 2-year period. The task force ultimately recommended that the definition of pain be revised to “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage,” and that the accompanying notes be updated to a bulleted list that included the etymology. The revised definition and notes were unanimously accepted by the IASP Council early this year.
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“The International Association for the Study of Pain also establishes a relationship between fear-painknowledge, as they state that pain not only represents the sensation of physical harm, but also an emotional experience that can be influenced by other emotions, such as anxiety or fear of the unknown [53].”
From Prevention of non-specific back pain through exercise and education: A systematic review and meta-analysis (2024) · cites this paper as [53]
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“experience of pain.(37) In addition, the term “unpleasant” has been debated as potentially trivializing the severe pain and suffering associated with many acute and chronic clinical pain states and fails to capture “the full range of words that could be used to describe the experience” and its associated suffering.”
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“The International Association of the Study of Pain (IASP) defines pain as ‘‘an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage’’ (Raja et al., 2020, p. 1).”
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“Pain is defined as an ‘unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage’ (Raja et al., 2020).”
BackgroundOsteoporosis treatment and pain relief: A scoping review
Pickering, M., Javier, R., Malochet‐Guinamand, S., Pickering, G. P., & Desmeules, J. A. (2023) · European Journal of Pain · doi:10.1002/ejp.2156 · Cited by 13
“…analgesics and adjuvants with adaptations to the older population, as aging is known to have an impact on the pain experience and on the pharmacology of drugs (Esses et al., 2020; Iwahashi et al., 2022; Pickering et al., 2016; Pickering & Chapurlat, 2020; Raja et al., 2020; Scholz et al., 2019).”
BackgroundRivi, V., Rigillo, G., Toscano, Y., Benatti, C., & Blom, J. M. C. (2023) · Children · doi:10.3390/children10071217 · Cited by 14
“Pain can be defined as an ‘unpleasant experience associated with, or resembling that associated with, actual or potential tissue damage’ [30].”
BackgroundNilles, C., Williams, J. V. A., Patten, S. B., Pringsheim, T. M., & Orr, S. L. (2023) · Neurology · doi:10.1212/wnl.0000000000207738 · Cited by 14
Chronic non-cancer pain in adolescents: a narrative review
Silva, C., de Oliveira, D. A. C., Pestana‐Santos, M., Portugal, F., & Capelo, P. (2021) · Brazilian Journal of Anesthesiology (English Edition) · doi:10.1016/j.bjane.2021.04.033 · Cited by 10
Current terminology of chronic pain
Корячкин, В. А., Павловна, С. А., Владимирович, Х. В., Levin, Y. I., & Иванов, Д. О. (2021) · Regional Anesthesia and Acute Pain Management · doi:10.17816/1993-6508-2021-15-1-9-17 · Cited by 11
Yeşilot, S. B., Çiftçi, H., & Yener, K. (2022) · AORN Journal · doi:10.1002/aorn.13665 · Cited by 13
Wandrey, J. D., Behnel, N., Weidner, E., Dummin, U., von Dincklage, F., & Tafelski, S. (2022) · European Journal of Pain · doi:10.1002/ejp.2051 · Cited by 11
Epidemiology and economics of chronic and recurrent pain
Turk, D. C., & Patel, K. V. (2022) · Wiley eBooks · doi:10.1002/9781119701170.ch2 · Cited by 11
Rider, J. V., & Tay, M. C. (2022) · The Open Journal of Occupational Therapy · doi:10.15453/2168-6408.2027 · Cited by 10
Montero-Cuadrado, F., Barrero-Santiago, L., Llamas-Ramos, R., & Llamas-Ramos, I. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010185 · Cited by 10
Chen, Y., Wu, X., Li, J., Ren, Y., He, M., Zhai, X., Huang, C., & Chen, X. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1634724 · Cited by 10
Characterizing Pain Leading to Emergency Medical Services Activation in Heart Failure
Smith, A., Jung, M., Lee, C. S., & Pressler, S. J. (2021) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000878 · Cited by 10
Dassieu, L., Choinière, M., Saint-Jean, L., Webster, F., Peng, P., Buckley, N., Gilron, I., Williamson, O. D., Finley, G. A., Baerg, K., et al. (2022) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-022-02241-0 · Cited by 10
Bofanova, N. S., Tychkov, A. Y., Дятлов, А. В., Chernyshov, D. S., & Павлович, Н. А. (2022) · Russian Journal of Pain · doi:10.17116/pain20222002168 · Cited by 10
Provenzano, A. H., Åström, E., & Löwing, K. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-022-05825-5 · Cited by 10
Temporomandibular joint involvement in individuals with ankylosing spondylitis: A scoping review
de Holanda, G. A., de Holanda, T. A., Boscato, N., & Casarin, M. (2022) · Archives of Oral Biology · doi:10.1016/j.archoralbio.2022.105609 · Cited by 11
Chiu, H., Su, I.-W., Yu, Y.-W., Chen, Y.-C., Chen, C.-C., & Lin, J.-H. (2023) · BMJ Open Quality · doi:10.1136/bmjoq-2022-001982 · Cited by 11
Purcell, C., Duignan, C., Fullen, B. M., Ryan, S., Ward, T. E., & Caulfield, B. (2023) · British Journal of Sports Medicine · doi:10.1136/bjsports-2022-106380 · Cited by 10
Yoon, Y., Hwang, H.-J., Kim, J., Chung, K., Jang, S.-Y., Heo, S.-W., Lee, S., Kim, S.-Y., Song, H.-A., Hong, S., et al. (2023) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2023.114708 · Cited by 10
Wall, J., McGowan, E., Meehan, W. P., III, & Wilson, F. (2023) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2023.05.005 · Cited by 10
Leitner, A., Hanson, E., Soliday, N., Staats, P. S., Levy, R. M., Pope, J. E., Kallewaard, J. W., Doleys, D. M., Li, S., Weisbein, J. S., et al. (2023) · Journal of Pain Research · doi:10.2147/jpr.s411927 · Cited by 10
“CP is described as “biopsychosocial” due to the dynamic interaction between biological, psychological, and social factors in this disease condition.(2) A better understanding of mechanisms of pain and how to identify which are present in a particular patient is needed to select the best treatment options for each indi…”
BackgroundLee, S. Y., Kim, J. B., Lee, J. W., Woo, A., Kim, C. J., Chung, M. Y., & Moon, H. S. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12175476 · Cited by 10
“The International Association for the Study of Pain (IASP) defines pain as “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage,” and it is expanded upon with the addition of six key notes and the etymology of the word pain for further v…”
BackgroundEssential Oils - Recent Advances, New Perspectives and Applications
Jonas (2023) · Biochemistry · doi:10.5772/intechopen.107782 · Cited by 12
Ingelson, B., Dahlke, S., O’Rourke, H. M., & Low, G. (2023) · Pain Management Nursing · doi:10.1016/j.pmn.2023.10.004 · Cited by 10
Mazaheri, M., Crooijmans, R. F., Vereen, M., & Corten, E. M. L. (2023) · Wound Repair and Regeneration · doi:10.1111/wrr.13128 · Cited by 11
“14 Distraction can modulate pain perception as pain is a partially controlled cognitive process that relies on limited attentional resources.”
BackgroundWithin and Beyond the Binary: Sex and Gender Differences in Pain and Alcohol Use Disorder
Fitzpatrick‐Schmidt, T., & Edwards, S. (2023) · Current Addiction Reports · doi:10.1007/s40429-023-00534-y · Cited by 11
“Pain is defined as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” [9].”
Visual perspective and body ownership modulate vicarious pain and touch: A systematic review
Lisi, M. P., Fusaro, M., & Aglioti, S. M. (2024) · Psychonomic Bulletin & Review · doi:10.3758/s13423-024-02477-5 · Cited by 13
Unveiling the link between chronic pain and misuse of opioids and cannabis
Dagher, M., Alayoubi, M., Sigal, G. H., & Cahill, C. M. (2024) · Journal of Neural Transmission · doi:10.1007/s00702-024-02765-3 · Cited by 11
“Self-report data on chronic pain prevalence may not reflect the true prevalence as perceptions of pain, culture, and sociodemographic factors affect reporting, diagnosis, and treatment seeking (Peacock and Patel 2008; Raja et al. 2020).”
Metadata
- Authors
- Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., Keefe, F. J., Mogil, J. S., Ringkamp, M., Sluka, K. A., Song, X.-J., Stevens, B., Sullivan, M. D., Tutelman, P. R., Ushida, T., & Vader, K.
- Affiliations
- Johns Hopkins University (US)
- Tufts University (US)
- UNSW Sydney (AU)
- Aarhus University (DK)
- Heidelberg University (DE)
- The University of Melbourne (AU)
- Duke University (US)
- McGill University (CA)
- University of Iowa (US)
- Southern University of Science and Technology (CN)
- University of Toronto (CA)
- University of Washington (US)
- Dalhousie University (CA)
- Aichi Medical University (JP)
- Queen's University (CA)
- Corresponding author
- Raja, Srinivasa N.
- ORCID
- Venue
- Pain
- Published
- 2020-09
- Volume
- 161
- Issue
- 9
- Pages
- 1976-1982
- ISSN
- 0304-3959 (ISSN-L)
- 1872-6623
- PMC
- PMC7680716
- OpenAlex
- W3043476716
- Cited by
- 5,223
- References
- 34
- Citations by year
- 2026: 930 · 2025: 1042 · 2024: 1021 · 2023: 905 · 2022: 757 · 2021: 484 · 2020: 78
- FWCI
- 70.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- other-oa
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (P30AG064201, R01AG058702)
- National Cancer Institute (UG1CA189824)
- National Institute of Nursing Research (U2CNR014637, U24NR014637)
- National Institute of Neurological Disorders and Stroke (R01NS097221, R01NS026363, U24NS112873)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR073187, R01AR070875, UG3AR076387)
- National Center for Complementary and Integrative Health (U24AT010961, U24AT009676)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Social Sciences › Arts and Humanities › History and Philosophy of Science › Medicine, History, and Philosophy
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- pain definition, International Association for the Study of Pain, pain classification, concept of pain, tissue damage
- MeSH terms
- Humans, Pain
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