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Introduction

Defines pain and introduces the five key concepts in pain with online resources and books.

Introduction

Pain is a complex human experience and is an experience known to almost all of us (some people don’t feel pain).

Have you ever wondered about phantom limb pain or why pain might persist even though tissues have healed long ago, or just wanted to know why you get pain when you stub your toe? This expert guide is here to help you understand.

We will focus on some headings, some key concepts, and in some cases some illustrative examples. For the most part you will need to find the resources that further explain and explore the topics.

Pain definitions

A commonly used definition developed by multidisciplinary experts from the International Association for the Study of Pain (IASP):

"Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage" (IASP Taxonomy)

Companion definition to the IASP

Pain is a perception created by the brain in response to input from receptors (i.e. nociceptive, visual, proprioceptive, tactile) and the internal beliefs and emotions drawn from past learning. It is influenced by the state of the nervous system from past and present experiences (i.e. neuroplasticity, sensitivity), and associated with the priming of motor responses (i.e. activity in anterior cingulate cortex and primary motor cortex) and a heightened vigilance to the affected part of the virtual body.

(Adapted from Jones, L. (2007). Non-specific arm pain. In C. J. Partridge (Ed.), Recent Advances in Physiotherapy (pp. 142-158). Chichester, England: Wiley.)

Further definitions

5 Key Concepts of pain

The following concepts are explained in more detail in the 'Neuroscience' and 'Assessment and treatment' sections:

Concept 1

Nociceptive transmission is not pain.

Concept 2

Modulation of nociceptive transmission can occur in dorsal horn of spinal cord.

Concept 3

Pain is created by the brain in response to central and peripheral mechanisms.

Concept 4

Pain is multi-dimensional.

Concept 5

Treatment of pain generally consists of removing the nociceptive stimulus or blocking the nociceptive transmission.

IASP