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Related Experiment Videos

Is pain ever "normal"?

Ruth J Cronje1, Owen D Williamson

  • 1Scientific and Technical Communication Program, Department of English, University of Wisconsin, Eau Claire, Eau Claire, WI 54702, USA. cronjerj@uwec.edu

The Clinical Journal of Pain
|September 22, 2006
PubMed
Summary
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The International Association for the Study of Pain's (IASP) use of "normal" pain is scientifically unfounded. Removing this term from IASP terminology is recommended to improve patient pain management and prevent misuse by third parties.

Area of Science:

  • Medical Terminology
  • Pain Research
  • Clinical Psychology

Background:

  • The International Association for the Study of Pain (IASP) terminology relies on a "normal" pain standard.
  • The term "normal" lacks an official operational definition, leading to subjective clinical interpretations.
  • This "normal" paradigm influences clinician reasoning, potentially differentiating legitimate pain from malingering.

Purpose of the Study:

  • To critically analyze the IASP's use of "normal" pain as a reference standard.
  • To investigate the implications of an undefined "normal" pain concept in clinical practice.
  • To advocate for the removal of "normal" from IASP pain terminology.

Main Methods:

  • Conceptual analysis of the IASP's Pain Terminology.

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  • Review of evidence regarding pain perception, expression, and clinical assessment.
  • Critique of the "normal" pain standard in light of empirical evidence and statistical prototypes.

    • Main Results:

    • The IASP's "normal" pain standard is based on an unsubstantiated "folk" sense, not empirical evidence.
    • Evidence for consistency in pain experience/expression and clinician accuracy in veracity assessment is lacking.
    • The use of "normal" can lead to ineffective/inhumane pain management and arbitrary limitations on pain therapy.

    Conclusions:

    • The logical preconditions for an evidence-based "normal" pain prototype are not met.
    • The term "normal" should be removed from the IASP Pain Terminology.
    • Expunging "normal" is crucial for rational, humane, and equitable pain management.