The International Association for the Study of Pain (IASP) defines pain as:
This is quite a good definition of something which is very hard to define, but the significance of it is not immediately obvious. Let’s look at it.
An unpleasant, sensory and emotional experience…
Most people feel pain is an unpleasant sensation, and this is the sensory aspect, the nature of the pain (ache, sharp, burning) and where it is.
Pain is always an experience, in other words it is interpreted in the light of the person’s previous life, their experiences, their understanding and their history. This changes how the pain feels and what it means.
Pain also has an emotional aspect, it always makes us feel something about it. Slight irritation, frustration, anger, fed up, depression are all examples of possible reactions. These effects can alter the severity of the pain we feel and the meaning we give to the pain.
associated with actual or potential tissue damage…
It is normal to associate pain with tissue damage as this is the way we learn about pain when we are children. It hurts if you burn yourself, cut yourself or sprain your ankle and these are all times when we damage ourselves and need time to heal.
Pain can also warn us that if we keep on going with what we are doing then there will be damage, such as putting a hand on a hot object.
or defined in terms of such damage…
Here’s the rub! It doesn’t look that promising does it? But it holds one of the keys to understanding what is going on with pain, especially chronic pain.
Pain usually means damage, as mentioned above. But not always.
Take a headache for instance. Most of us have a bad headache from time to time, but I’d bet very few of us think any damage is going on in our head. Sure, it feels like it’s splitting! But do you go to the mirror just to check? Of course not. You know that even though it feels like damage, it is just a pain.
Our brains are programmed to interpret pain as damage, as that is the way we have been conditioned all our lives.
What happens then when we get a pain which is not (or no longer) due to present tissue damage? We still interpret (define) it in terms of tissue damage. All our past lives have told us that pain means damage and the words we use reflect this - sharp, shooting, strain, pulling, pressure, inflamed, injured.
Problems occur with this way of understanding the meaning of pain when we have a chronic (long lasting) pain and try to interpret it in terms of tissue damage or injury. This can cause conflict, frustration and anger, confusion, investigation seeking, treatment seeking and a loss of confidence and trust in medical and allied opinions.
To follow my argument further see acute vs chronic pain, which illustrates the meanings of these types of pain and the way we need to understand them.