# The definition of pain ##### Untangling Pain --- ![](https://youtu.be/FYqGhzOKrwE) --- ## tl;dr **The New Definition** - Pain is unpleasant - It can produce a sensory response - It can be an emotional experience - It is associated with real or perceived potential tissue damage **Pain Is Complex** - Pain isn’t black and white - It can be adaptive or maladaptive - It affects our mental and social health **Pain Is Personal** - Shaped by biological, psychological, social, and spiritual factors - It’s not just about what’s happening in our body **Why Biomechanics Wasn’t Enough** - I used to focus on biomechanics, injuries, the remedial side - But pain persisted even when the injury healed - There were psychological and social factors too **Believe People’s Pain** - Pain is real and valid, even when nothing shows on scans - Especially for women who’ve been gaslighted for years - Pain deserves respect **Real or Perceived Damage** - Our brain may think we’re in danger and create pain - It’s not about imagining pain, it’s a real brain response **Is It All in Your Head?** - Yes and no - It’s complex - I’ll break it down for you --- ## Transcript In 2020, the International Association for the Study of Pain, the IASP, updated their definition of pain. And this was the first time since 1979. The new definition of pain states that pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. That's a bit of a mouthful. What does this actually mean? This means... One, pain is unpleasant. No shit. Number two - it can produce a sensory response. Basically, it affects our senses. Number three. It can also be an emotional experience. Again, no shit. Number four - it is associated with real or perceived potential tissue damage. So they've updated this definition of pain and when they were writing this up, they wanted to "better reflect its complexity and nuance" Basically pain isn't black and white. We know that. They were hoping that this new definition would lead to better assessments and treatment for those living with pain. So this updated version, it acknowledges that pain actually serves a purpose. It serves an adaptive role. Warning us when something's wrong. But the thing is, pain can also become what's called maladaptive. So it can seriously mess with our ability to function. And it can take a toll on our mental health. And it can take a toll on our social health. The other thing is that I think with the definition is it explains that pain is always personal .That it's not just about what's happening in our body. It's shaped by the biological, by the psychological, by social factors. As well as spiritual factors, which I will talk about another time. Not spiritual as in woo-woo, but you will see when I talk about spiritual factors. It's why so many therapists now are leaning on this biopsychosocial approach. It's holistic. It's taking into account the bigger picture. Pain is not just biological. I suppose that was why I struggled a bit when I was focused primarily on biomechanics, that people coming to me with pain and I was looking at the biomechanics, the remedial side, the injuries and everything else. Yes, there may be a biological aspect to it. But it wasn't just biological. There were other factors involved, a lot of psychological factors, a lot of social factors, a lot of factors that were influencing pain in this person. So yes, I could say this is the biological side, this is the biomechanics of it or whatever it might be, this is the injury that you've had. But actually that injury now is healed and they're still wondering why they're still in pain even though the biological side has been fixed. And that's because pain isn't just biological, there's so much other stuff going on. The other thing with this definition as well, it helps to explain that pain is personal. So, if somebody tells you they're in pain, believe them. Please believe them. It doesn't matter what's causing it, or what you think is causing it, or what everybody, anybody else thinks is causing it. Pain is pain. It's real. It's valid. Pain is pain. Deeply personal, and it is really fucking complex. And this new definition, it sort of shines more of a light on all of that. It's not a perfect definition by any means, but it is better and it's getting better. And it's about time that pain got the respect it deserves. And especially as women, we have been Gaslighted for so many years. Nobody believing when we say we're in pain. Because sometimes there's nothing physical that they can see on scans or tests. But just because they can't see it, or just because we can't see it, doesn't mean pain is not real. It is real. It is really real. So, on that note point number four is really important to note. Pain is associated with real or perceived potential tissue damage. I'm hoping you got that bit. Real. Or perceived. It's not perceived as in you perceiving it or you perceiving pain. It's not that. What happens is sometimes our bodies think that we are in danger, and it produces pain as a way to alert us, when there's actually nothing going on in the body. So again, this is not us perceiving there is pain. It is our brain that perceives that we are in danger. Or we are in potential danger. It tries to work out what's going to happen as well and predict what's going to happen. So again, it is our brain that perceives that we are in danger and as a result, it produces pain. And it produces pain to alert us to that danger. When I've explained this to people before, the response I often get is, does this mean that pain is all in my head? And the answer is... yes and no. This is complex. And I'm going to try and break it down for you as simply as I can. So this has taken years to develop this thinking, and this is what I'm going to teach you now. --- Next lesson → [[Untangling Pain – Module 1 Lesson 03|next lesson]] %% - [[The Updated Definition of Pain]] - [[The Complexity and Nuance of Pain]] - [[Pain Serves a Purpose]] - [[Pain Is Always Personal]] - [[The Biopsychosocial Approach to pain]] - [[My Struggle with a Biomechanical Focus of pain]] - [[The Injury May Heal, But the Pain Can Remain]] - [[Pain Is Valid and Real]] - [[Gendered Experiences of Pain means as women we have been gaslighted around pain]] - [[pain is associated with real or perceived potential tissue damage]] - [[is pain all in your head? yes and no]]