In the current series of posts I’ll be discussing the treatment of pain and how this creates difficulties for effective assessment, using the SOAP method for doctors’ diagnosis. It seems though that before becoming fully immersed in these discussions, it would be useful to be clear about our terms. What exactly is pain, anyway?
The International Association for the Study of Pain (IASP) defines pain as, “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such.” Note that, by definition, pain is always subjective. Each of us learns the application of the term through experiences related to injury in early life. Pain is that experience we associate with actual or potential tissue damage. “It is unquestionably a sensation in part or parts of the body, and it is always unpleasant – and therefore it is also an emotional experience.” (IASP LINK TO SOURCE)
Unpleasant, abnormal experiences, “dysesthesia,” are not necessarily painful by IASP’s definition, because they may not have the usual sensory qualities of pain. This means that pain perception is conditioned. In certain circumstances stimuli not normally perceived as painful can be recorded as extremely painful. Alterations in the central nervous system (neural sensitization) have also been suggested as an explanation for the persistence of pain. (Purves, 2004, pp.209- 228)
So, then, if pain is subjective, and subject to varying forms of experience and perception, perhaps the next question that needs to be addressed is how precisely do we register pain. I’ll address that question in my next post. See you then.