Cited by 5,223Pain Mechanisms and TreatmentsMedicine, History, and PhilosophyPain Management and Treatment

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The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises

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Raja, Srinivasa N., Carr, Daniel B., Cohen, Milton, Finnerup, Nanna B., Flor, Herta, Gibson, Stephen, Keefe, Francis J., Mogil, Jeffrey S., Ringkamp, Matthias, Sluka, Kathleen A., Song, Xue-Jun, Stevens, Bonnie, Sullivan, Mark D., Tutelman, Perri R., Ushida, Takahiro, Vader, Kyle·2020·Pain

DOI 10.1097/j.pain.0000000000001939PMC PMC7680716

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Abstract

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 qualitative content analysis process
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Method
Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11)
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Background
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Characterizing pain in long-term survivors of childhood cancer
Patton, M., Forster, V. J., Forbes, C., Stokoe, M., Noel, M. E., Carlson, L. E., Birnie, K. A., Reynolds, K. A., & Schulte, F. (2021) · Supportive Care in Cancer · doi:10.1007/s00520-021-06386-4 · Cited by 27
Resolvins: Potent Pain Inhibiting Lipid Mediators via Transient Receptor Potential Regulation
Roh, J., Go, E. J., Park, J., Kim, Y. H., & Park, C. (2020) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2020.584206 · Cited by 30
Health Care Providers' Experiences of the Non-Pharmacological Pain and Anxiety Management and Its Barriers in the Pediatric Intensive Care Units
Sabeti, F., Mohammadpour, M., Pouraboli, B., Tahmasebi, M., & Hasanpour, M. (2021) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2021.07.026 · Cited by 27
The relationship between chronic pain and psychosocial aspects in patients with haemophilic arthropathy. A cross‐sectional study
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Role of Occupational Therapy in Pain Management
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User-Centric Design Methodology for mHealth Apps: The PainApp Paradigm for Chronic Pain
Koumpouros, Y. (2022) · Technologies · doi:10.3390/technologies10010025 · Cited by 27
Normalization of Neuroinflammation: A New Strategy for Treatment of Persistent Pain and Memory/Emotional Deficits in Chronic Pain
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Thalamocortical Circuit Controls Neuropathic Pain via Up-regulation of HCN2 in the Ventral Posterolateral Thalamus
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Racism as a Source of Pain
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Differential Effects of Regulatory T Cells in the Meninges and Spinal Cord of Male and Female Mice with Neuropathic Pain
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Taking AI Welfare Seriously
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The pathophysiology, assessment, and management of acute pain
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Brain nuclei and neural circuits in neuropathic pain and brain modulation mechanisms of acupuncture: a review on animal-based experimental research
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“However, because pain is essentially an unpleasant emotional experience (Raja et al., 2020), the symptoms of NP patients are often accompanied by sleep disturbances, anxiety, depression, and cognitive impairment in addition to the pain itself, and their quality of life is understandably much lower than that of non-NP…”
Background
The Locus Coeruleus in Chronic Pain
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Background
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VTA-NAc glutaminergic projection involves in the regulation of pain and pain-related anxiety
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Nociception Level Index–Guided Intraoperative Analgesia for Improved Postoperative Recovery: A Randomized Trial
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The Role of Pain Catastrophizing, Emotional Intelligence, and Pain Intensity in the Quality of Life of Cancer Patients with Chronic Pain
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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: Raja, Srinivasa N.
Cohen, Milton
Finnerup, Nanna B.
Flor, Herta
Gibson, Stephen
Keefe, Francis J.
Mogil, Jeffrey S.
Ringkamp, Matthias
Sluka, Kathleen A.
Song, Xue-Jun
Stevens, Bonnie
Sullivan, Mark D.
Tutelman, Perri R.
Ushida, Takahiro
Vader, Kyle
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2020-09
Volume: 161
Issue: 9
Pages: 1976-1982
ISSN: 0304-3959 (ISSN-L)
1872-6623
DOI: 10.1097/j.pain.0000000000001939
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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The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises

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