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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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Cites
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“An illustrative example is the discordance between reports of pain and the structural abnormalities visualized by imaging in patients with knee osteoarthritis.(6,30,36) The IASP has defined nociplastic pain as “pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage ca…”
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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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Chronic pain: an update on burden, best practices, and new advances
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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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