The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises

Pain - Tập 161 Số 9 - Trang 1976-1982 - 2020
Srinivasa N. Raja1, Daniel B. Carr2,3,4, Milton Cohen3,5,4, Nanna Brix Finnerup6,7,3,4, Herta Flor8,3,4, Stephen Gibson9,3,4, Francis J. Keefe10,3,4, Jeffrey S. Mogil11,3,4, Matthias Ringkamp12,3,4, Kathleen A. Sluka13,3,4, Xue‐Jun Song14,3,4, Bonnie Stevens15,3,4, Mark D. Sullivan16,3,4, Perri R. Tutelman17,3,4, Takahiro Ushida18,3,4, Kyle Vader19,3,4
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
2Program in Public Health and Community Medicine, Department of Anesthesiology and Perioperative Medicine, Tufts University School of Medicine, Boston, MA, United States
3Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
4Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com).
5St Vincent's Clinical School, UNSW Sydney, Sydney, New South Wales, Australia
6Department of Clinical Medicine, Danish Pain Research Center, Aarhus University, Aarhus, Denmark
7Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
8Institute of Cognitive and Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
9Caulfield Pain Management and Research Centre, University of Melbourne, Melbourne, Australia
10Duke Pain Prevention and Treatment Research Program, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
11Departments of Psychology and Anesthesia, McGill University, Montreal, QC, Canada
12Department of Neurosurgery, Johns Hopkins University, School of Medicine, Baltimore, MD, United States
13Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, United States
14SUSTech Center for Pain Medicine, Southern University of Science and Technology School of Medicine, Shenzhen, Guangdong, China
15Lawrence S Bloomberg Faculty of Nursing, Faculties of Medicine and Dentistry, University of Toronto, Toronto, ON, Canada
16Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
17Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
18Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Aichi, Japan
19School of Rehabilitation Therapy, Queen's University, and Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, ON; Chronic Pain Clinic, Kingston Health Sciences Centre, Kingston, ON, Canada

Tóm tắt

Abstract 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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Tài liệu tham khảo

Alcock, 2017, Defining pain: past, present, and future, PAIN, 158, 761, 10.1097/j.pain.0000000000000828

Anand, 1996, New perspectives on the definition of pain, PAIN, 67, 3

Anand, 1999, Consciousness, behavior, and clinical impact of the definition of pain, Pain Forum, 8, 64, 10.1016/S1082-3174(99)70029-2

Aydede, 2017, Defending the IASP definition of pain, Monist, 100, 439, 10.1093/monist/onx021

Aydede, 2019, Does the IASP definition of pain need updating?, Pain Rep, 4, e777, 10.1097/PR9.0000000000000777

Bedson, 2008, The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature, BMC Musculoskelet Disord, 9, 116, 10.1186/1471-2474-9-116

Bonica, 1979, The need of a taxonomy, PAIN, 6, 247, 10.1016/0304-3959(79)90046-0

Ceusters, 2015, Perspectives on next steps in classification of oro-facial pain—Part 1: role of ontology, J Oral Rehabil, 42, 926, 10.1111/joor.12336

Cohen, 2018, Reconsidering the International Association for the Study of Pain definition of pain, Pain Rep, 3, e634, 10.1097/PR9.0000000000000634

Craig, 2017, Reply, Pain, 158, 363, 10.1097/j.pain.0000000000000766

Cunningham, 1998, Comments on derbyshire, PAIN, 67 (1996) 210–11, PAIN, 74, 102

Cunningham, 1999, Primary requirements for an ethical definition of pain, Pain Forum, 8, 93, 10.1016/S1082-3174(99)70033-4

Davis, 2017, Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations, Nat Rev Neurol, 13, 624, 10.1038/nrneurol.2017.122

Derbyshire, 1996, Comment on editorial by Anand and Craig, PAIN, 67, 210, 10.1016/0304-3959(96)03170-3

Elo, 2008, The qualitative content analysis process, J Adv Nurs, 62, 107, 10.1111/j.1365-2648.2007.04569.x

Fields, 1999, Pain: an unpleasant topic, PAIN, S61, 10.1016/S0304-3959(99)00139-6

1979, Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy, PAIN, 6, 249

Jensen, 2011, A new definition of neuropathic pain, PAIN, 152, 2204, 10.1016/j.pain.2011.06.017

Jensen, 2008, New pain terminology: a work in progress, PAIN, 140, 399, 10.1016/j.pain.2008.10.014

Kosek, 2016, Do we need a third mechanistic descriptor for chronic pain states?, PAIN, 157, 1382, 10.1097/j.pain.0000000000000507

Loeser, 2008, The Kyoto protocol of IASP basic pain terminology, PAIN, 137, 473, 10.1016/j.pain.2008.04.025

Merskey, 1994, Logic, truth and language in concepts of pain, Qual Life Res, 3, S69, 10.1007/BF00433379

Nugraha, 2019, The IASP classification of chronic pain for ICD-11: functioning properties of chronic pain, PAIN, 160, 88, 10.1097/j.pain.0000000000001433

Osborn, 2018, Situating pain in a more helpful place, Pain Rep, 3, e642, 10.1097/PR9.0000000000000642

Schiphof, 2013, Factors for pain in patients with different grades of knee osteoarthritis, Arthritis Care Res (Hoboken), 65, 695, 10.1002/acr.21886

Tesarz, 2017, A conceptual framework for “updating the definition of pain”, PAIN, 158, 1177, 10.1097/j.pain.0000000000000878

Treede, 2018, The International Association for the Study of Pain definition of pain: as valid in 2018 as in 1979, but in need of regularly updated footnotes, Pain Rep, 3, e643, 10.1097/PR9.0000000000000643

Treede, 2019, Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the international classification of diseases (ICD-11), PAIN, 160, 19, 10.1097/j.pain.0000000000001384

Treede, 2015, A classification of chronic pain for ICD-11, PAIN, 156, 1003, 10.1097/j.pain.0000000000000160

Wenham, 2009, Imaging the painful osteoarthritic knee joint: what have we learned?, Nat Clin Pract Rheumatol, 5, 149

Williams, 2016, Updating the definition of pain, PAIN, 157, 2420, 10.1097/j.pain.0000000000000613

Woo, 2017, Quantifying cerebral contributions to pain beyond nociception, Nat Commun, 8, 14211, 10.1038/ncomms14211

Wright, 2011, A criticism of the IASP's definition of pain, J Conscious Stud, 18, 19

Wright, 2017, Critical comments on Williams and Craig's recent proposal for revising the definition of pain, PAIN, 158, 362, 10.1097/j.pain.0000000000000765