What is pain?

Until fairly recently, the prevailing view was that pain is a result of damage to the body. In the seventeenth century the French philosopher Rene Descartes developed a “rope-pull” model of pain. Just as pulling a rope in a church tower rings the bell, Descartes thought that tissue damage in the body is a tug that causes the sensation of pain in the brain. Following Descartes, for centuries Western doctors regarded pain as a sensation that could be explained by neurology. The intensity of the pain was thought to be directly proportional to the degree of damage to the body, which would mean that if different people had the same injury they would experience the same pain. If no obvious physical cause could be found, often the patient would be accused of malingering.

However, in the last half-century views of pain have changed dramatically as scientists discovered the extent to which it involves the whole person—the mind as well as the body—and research using modern neuroimaging methods showed how complex pain is. The leading professional body of pain specialists, 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 which is described in terms of such damage.” They add that “pain is always subjective” (International Association for the Study of Pain 1994, p. 210). The key point is that pain is an experience and emotions, beliefs, and attitudes, as well as past experiences, all play a role in how the experience we label “pain” is perceived (Bond and Simpson 2006, p. 4).

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