A new definition of 'pain': an imperative of our times

Abstract

Over the past fifty years, the subject of pain and its management has gained worldwide recognition, not only as a medical specialty, but also as a subject for both scientific research and philosophical analysis. In keeping with this interest, a number of approaches from a variety of disciplines have been considered, studied and/or developed, in an attempt to further a scientific and humanitarian understanding of the condition and optimize the treatment thereof. These approaches include the bio-psychological approach, multidisciplinary treatment, theories on modulation, the palliative approach, pain behavior methodology, and the use of psychological strategies. In addition, studies on membrane channels and receptors, neuropathic pain states and their changes within the nervous system, disruption using chemical agents on the channels involved in pain transmission, disruption of RNA transcription, the chemical alteration of central processes, the use of implantable neuromodulators, infusion devices, intradiscal interventions, radiofrequency related technologies and many more, bring us closer to understanding the phenomenon of pain and how it can be more effectively prevented, managed or eliminated. Many of the advances made in the area of pain understanding and treatment are due to the invaluable contributions and dedication of such great people as John Bonica,1 Romald Melzack,2 Patrick Wall,2 Prithvi Raj,3 Menno E. Sluijter,4 Gabor Racz5 and Ricardo Plancarte,6 to name just a few. However, let us not forget the humble professional who treats pain with the means available to him or her, and does so without appearing in the forum of the world-renowned. The work of these individuals undoubtedly deserves much admiration, respect and recognition. In addition, many other disciplines have contributed with valuable studies on the subject of pain, which offer the perspective of its broad implications in all aspects of society and on the general quality of human life. Most recently, a humanistic and legal analysis, recognizing pain as the most terrible flagellation of mankind since its origins7 and as a disease in its own right8 brought about worldwide recognition of the related proposition for the recognition of the Treatment of Pain as a Fundamental Human Right. The above brings deserved justice to fathers of the Universal Declaration of Human Rights9 on their awareness and recognition of human suffering due to pain, and the implicit inclusion of the right to its treatment within the right