Adieu to an aphorism: why nociception is necessary for pain

Key Points

1. An aphorism is a short saying intended to express a general truth.

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BACKGROUND & OBJECTIVE

In this literature review and critical examination, the authors argue there is a logical contradiction between the aphorism “nociception is neither necessary nor sufficient for pain” and the revised IASP definition of pain being “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”.

They argue that the IASP definition does not define tissue damage and “that signalling that damage is threatened or has occurred should be referred to as nociception”, which occurs via the nociceptive apparatus. Therefore, the claim that nociception is not required for pain appears to contradict the very definition of pain itself.

In this literature review they aimed to show that the proposition that a person could experience pain without activation of the nociceptive apparatus, was not supported by empirical clinical or experimental evidence. After this the objective was to suggest revision on the aphorism and IASP definition.

The claim that nociception is not required for pain appears to contradict the very definition of pain itself.

Accepting nociception is necessary for pain may indicate psychological and social factors are not necessary for a pain experience, however their modifying influences must remain as important components in management.

METHODS

One author (AW) performed an extensive literature search across Google Scholar, Medline & PubMed. Searches for publications containing phrases specifically related to the relationship between nociception and pain were performed. Primary analysis was performed to ensure suitability and quality. A

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