Jul 27, 2018
When starting out researching and learning about pain, as part of my Pain Science learning plan over the last 2 months, I have found one constant theme; pain is a complex thing and therefore defining it is also a very difficult. The fact is that even the definition of pain is an evolving changing definition over time.
Let us start back in 350BC where Aristotle stated “We measure our actions by the rule of pleasure and pain. For this reason, then, our whole enquiry must be about these.’ Pain is not one of the five senses but is a ‘passion of the soul.’ Even this far back in Aristotle’s time he came to a conclusion that pain affects us socially and a personal level.
Rene Descartes (1596-1650), a French Scientist and philosopher, said, “Pain is a specific alarm system”. Meaning that pain tells the body that something negative is happening and to react to it. One could argue that this definition could be a primitive definition of what we now call nociceptive pain: is a response to noxious stimuli (thermal, mechanical or chemical). Figure 1. Shows some early illustrations Descartes made as a pain pathway.
However we do know now how Descartes defined pain isn’t 100% true, that pain pathways are much more complicated and that there are many factors influencing the perception on pain in the central nervous system. Although pain can alert us of danger or tissue damage, it is not always the case. Currently the most popular definition of pain comes from International Association for the Study of Pain. They suggest ‘Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.’ Even this definition falls under some scrutiny with many people arguing pain always has a contextual component to it and social factors can also affect the experience.
This is where Butler and Moseley’s research comes in with the Biopsychosocial Model of pain. In future blogs I’ll talk more about the Biospychosocial model in detail.
From reading all of this one might be even more confused on how pain is defined. And I would agree with you, pain is a multifaceted thing. Therefore you can see how complex pain is when a patient is communicating and describing what they are feeling to a health care professional. Not only that, the way the health care professionals communicates with their patient can also affect how pain is perceived. This is why this topic is so interesting to me, because there is no simple way to define pain.
Follow me on Twitter on @BPowelske or activephysioworks.com for frequent pain blogs as I continue with my pain science/ pain management education and professional development over the next 18 months. To book an appointment with Brandyn, call 780-458-8505.