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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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BackgroundUpdating the definition of pain
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“According to the revised 2020 definition of the International Association for the Study of Pain, pain is “an unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage” [11].”
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“Defined by IASP in 2020, pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage [7,8].”
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“This suggests that pain transcends being just a physical sensation [68].”
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Exploring the Role of Community Pharmacists in Pain Management: Enablers and Challenges
Mujtaba, S. H., & Gazerani, P. (2024) · Pharmacy · doi:10.3390/pharmacy12040111 · Cited by 18
“Pain [1] is a complex phenomenon influenced by biological, psychological, emotional, and cultural factors, making it highly individualized [2].”
BackgroundMartorell, M. M., Bruniges, N., Martinez, M., Maddox, T. W., & Robson, K. (2024) · Animals · doi:10.3390/ani14162310 · Cited by 14
“The 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” [1,2].”
BackgroundHe, Z., Li, G., Chen, Z., Hu, Z., Wang, Q., Huang, G., & Luo, Q. (2024) · Age and Ageing · doi:10.1093/ageing/afae183 · Cited by 16
The role and treatment potential of the complement pathway in chronic pain
Vygonskaya, M., Wu, Y., Price, T. J., Chen, Z., Smith, M. T., Klyne, D. M., & Han, F. Y. (2024) · Journal of Pain · doi:10.1016/j.jpain.2024.104689 · Cited by 14
Tatikola, S. P., Natarajan, V., Amaravadi, S. K., Desai, V. K., Asirvatham, A. R., & Nagaraja, R. (2024) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2024.11.016 · Cited by 16
Faces of Experimental Pain: Transferability of Deep-Learned Heat Pain Features to Electrical Pain*
Prajod, P., Schiller, D., Don, D. S. W., & André, E. (2024) · International Conference on Affective Computing and Intelligent Interaction Workshops and Demos (ACIIW) · doi:10.1109/aciiw63320.2024.00009 · Cited by 14
“The International Association for the Study of Pain (IASP) describes pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” [2].”
Synthetic Thermal and RGB Videos for Automatic Pain Assessment Utilizing a Vision-MLP Architecture
Gkikas, S., & Tsiknakis, M. (2024) · International Conference on Affective Computing and Intelligent Interaction Workshops and Demos (ACIIW) · doi:10.1109/aciiw63320.2024.00006 · Cited by 14
“Pain, as defined by the International Association for the Study of Pain (IASP), is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” [1].”
Time course of DNA methylation in pain conditions: From experimental models to humans
Johansen, L. M., Gerra, M. C., & Arendt‐Nielsen, L. (2020) · European Journal of Pain · doi:10.1002/ejp.1674 · Cited by 14
Telerehabilitation for Pain Management
Nanda, U., Luo, J., Convery, Q. W., & Pangarkar, S. S. (2021) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2021.01.002 · Cited by 14
Spiritual Pain: A Symptom in Search of a Clinical Definition
Illueca, M., Bradshaw, Y. S., & Carr, D. B. (2022) · Journal of Religion and Health · doi:10.1007/s10943-022-01645-y · Cited by 17
Self-citationFactors affecting the prevalence, severity, and characteristics of ocular surface pain
Sánchez, V., Cohen, N. K., Felix, E. R., & Galor, A. (2022) · Expert Review of Ophthalmology · doi:10.1080/17469899.2023.2157813 · Cited by 14
Chronic Pain: Evolution of Clinical Definitions and Implications for Practice
Mailis, A., Tepperman, P. S., & Hapidou, E. G. (2020) · Psychological Injury and Law · doi:10.1007/s12207-020-09391-w · Cited by 15
Gonzalez, M. N., Trehan, G., & Kamel, I. (2021) · Topics in Pain Management · doi:10.1097/01.tpm.0000767384.20129.5c · Cited by 14
Four decades later: what's new, what's not in our understanding of pain
Turner, J. A., & Arendt‐Nielsen, L. (2020) · Pain · doi:10.1097/j.pain.0000000000001991 · Cited by 14
Wei, N., Guo, Z., Ye, R., Guan, L., Ren, J., Liang, Y., Shao, X., Fang, J., Fang, J., & Du, J. (2025) · IBRO Neuroscience Reports · doi:10.1016/j.ibneur.2025.02.015 · Cited by 14
“Pain is characterized by three specific dimensions: sensory-discriminative, emotional-affective, and cognitive-evaluative (Raja et al., 2020).”
Injury-Driven Structural and Molecular Modifications in Nociceptors
García‐Domínguez, M. (2025) · Biology · doi:10.3390/biology14070788 · Cited by 18
“The International Association for the Study of Pain (IASP) describes pain as “an un-pleasant sensory and emotional experience often associated with actual or potential tissue damage” [1,2].”
Fernandez-Rojas, R., Joseph, C., Hirachan, N., Seymour, B., & Goecke, R. (2026) · International Conference on Affective Computing and Intelligent Interaction Workshops and Demos (ACIIW) · doi:10.1109/aciiw71585.2026.11712097 · Cited by 13
“Pain is a complex and multidimensional experience that plays a critical role in clinical diagnosis, treatment planning, and patient monitoring [3].”
Pain Modulates Responses to Emotional Stimuli
Li, W., Liu, P., Hu, Y., & Meng, J. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.595987 · Cited by 13
Wang, J., Wen, W., Gong, D., Chen, Q., Li, P., Liu, P., Wang, F., & Xu, S. (2021) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2021.114780 · Cited by 13
Nedeljković, S. S., Song, I., Bao, X., Zeballos, J., Correll, D., Zhang, Y., Ledley, J., Bhandari, A. A., Bai, X. S., Lee, S. R., et al. (2021) · Journal of Clinical Anesthesia · doi:10.1016/j.jclinane.2021.110576 · Cited by 13
fNIRS brain measures of ongoing nociception during surgical incisions under anesthesia
Green, S., Karunakaran, K. D., Labadie, R., Kussman, B., Mizrahi-Arnaud, A., Morad, A. G., Berry, D., Zurakowski, D., Micheli, L. J., Peng, K., et al. (2022) · Neurophotonics · doi:10.1117/1.nph.9.1.015002 · Cited by 13
Chronic Pain in Spanish Wildland Firefighters
García-Heras, F., Gutiérrez-Arroyo, J., León-Guereño, P., Carballo-Leyenda, B., & Marroyo, J. A. R. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11040989 · Cited by 16
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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