One of the biggest barriers affecting people live with chronic pain is not being taken seriously or believed – particularly if the pain has an invisible cause. This barrier can result in lack of proper medical care and understanding among friends, coworkers and even family members.
In 1979, the International Association for the Study of Pain (IASP) defined pain as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” While this definition may have described acute pain, such pain from a broken ankle, surgery, or an infection, it doesn’t cover the many types of chronic pain experienced by over 50 million adults in the United States. Now, 41 years later, the IASP has issued a new pain definition: “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” The revised definition is close to the original, but with an important difference. It acknowledges that chronic or ongoing pain may not cause tissue damage at all, yet the pain continues.
Why Change the Definition?
“We hope that the revised definition and accompanying notes will be useful in increasing patients’ and healthcare providers’ understanding of pain as a sensory and emotional experience that may or may not be associated with tissue damage,” Judith A. Turner, PhD, a professor at the University of Washington, in Seattle, told Medical Daily. “If this understanding is shared by patients and their providers, patient-provider communication and agreement on optimal treatment can be improved.”
It’s important for people living with pain, she said, along with their family and their healthcare providers to all understand that pain can result from factors other than tissue damage, which is what the original definition said. “Pain is just as “real” as the pain caused by tissue damage. [It] is influenced by biological and psychosocial factors, and these influences need to be assessed and targeted by treatment.”
Common Causes of Chronic Pain
Chronic pain has many causes, but the most common in the U.S. include:
- Headaches and migraines
- Back pain
- Cancer
- Arthritis
There are also syndromes, like fibromyalgia or phantom limb pain, a group of symptoms and signs that together define a disease or disorder, that have no obvious source and yet, they can cause debilitating pain.
Treating chronic pain is difficult and often takes some trial and error to find treatment that works. But before diagnosis and treatment, healthcare providers must recognize the effect of pain on their patients and that to the patients, the pain is real whether they can see it or not. “Pain is a personal experience that can be influenced by biological factors not limited to tissue damage, the individual’s thoughts and feelings, and social factors,” Turner explained. “It can be felt in a part of the body that is not actually involved in generating the pain experience.” Like lower back pain: It can make your sciatic nerve, that thick nerve that runs on either side of you from your hips down to your knees, hurt.
Pain can and does save lives. It tells us when things aren’t right with our body and it can keep us from doing dangerous things, like putting our hand on a hot surface. But when pain – specifically chronic pain – is debilitating, it often affects quality of life both physically and mentally. It does so, regardless of whether the pain is visible or not.