Logic, truth and language in concepts of pain

Abstract

Logic and language influence our ideas about the truth of pain, and can alter our understanding of it. Physicians should not tell their patients that there is nothing wrong with them if all their test results are negative, as this denies their patients' experiences of pain. Popular methods of conceptualizing pain may be erroneous. Diagrams of pain or disability are misleading and unhelpful--it is not usually possible to distinguish their components in practice. Giving patients a high or low score for pain behaviour, depression or for health locus of control can influence our views on aetiology in a seriously misleading way. Anyway, aetiological attributions are not always possible from analyses of the experience of pain. The problems of logic and language inherent in assigning pain to emotional causes, in using behavioural approaches, and in defining idiopathic pain and somatization are discussed. The IASP definition of pain is important and useful, provided that it is used appropriately. The recommended version is now 'an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.'