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A Call for Study on the Meanings of Pain

  • Simon van RysewykEmail author
Chapter

Abstract

Pain always appears in a particular way, so perceived meaning is extremely important in the way that pain is felt. However, this essential aspect of pain remains poorly understood in pain research and clinical contexts. What meanings matter most to patients with pain? How do such meanings change over time and how do they interact with neurophysiological activity and therapeutic outcomes? The study of the meanings of pain using valid qualitative or mixed methods can be usefully integrated into the quantitative medical evidence-base and into evidence-based medical practice.

Keywords

Chronic Pain Pain Experience Sensory Quality Common Meaning Interpretative Phenomenological Analysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

I warmly thank all authors for their excellent contributions. For support in conceiving this project, I am grateful to Professor Emeritus Donald D. Price (University of Florida, Gainesville), Professor Emeritus John Loeser (University of Washington), Professor Lorimer L. Moseley (University of South Australia), and anonymous reviewers of my book proposal. I thank the publishing team at Springer for its kindness and flexibility, especially Neil Solomon (Associate Editor, Neurosciences, Pharmaceutical Sciences, Protocols), and Abirami Purushothaman (Production).

References

  1. Arntz A, Claassens L (2004) The meaning of pain influences its experienced intensity. Pain 31(109):20–25CrossRefGoogle Scholar
  2. Asmundson GJG, Wright K (2004) Biopsychosocial approaches to pain. In: Hadjistavropoulos T, Craig KD (eds) Pain: psychological perspectives. Erlbaum, Mahwah, pp 35–57Google Scholar
  3. Avila LA (2013) Pain beyond biology. Pain 154:2571–2572CrossRefPubMedGoogle Scholar
  4. Basbaum AI, Fields HL (1984) Endogenous pain control systems: brainstem spinal pathways and endorphin circuitry. Ann Rev Neuros 7:309–338CrossRefGoogle Scholar
  5. Benedetti F, Thoen W, Blanchard C, Vighetti S, Arduino C (2013) Pain as a reward: changing the meaning of pain from negative to positive co-activates opioid and cannabinoid systems. Pain 154:361–367CrossRefPubMedGoogle Scholar
  6. Bustan S (ed) (in press) Fundamental transdisciplinary questions on suffering and pain. Springer, New York Google Scholar
  7. Butler D, Moseley GL (2003) Explain pain. Noigroup Publications, Adelaide Google Scholar
  8. Cassell EJ (1991) The nature of suffering. Oxford University Press, LondonGoogle Scholar
  9. Cedraschi C, Delézay S, Marty M, Berenbaum F, Bouhassira D, Henrotin Y, Laroche F, Perrot S (2013) “Let’s talk about OA pain”: a qualitative analysis of the perceptions of people suffering from OA. Towards the development of a specific pain OA-Related Questionnaire, the Osteoarthritis Symptom Inventory Scale (OASIS). PLoS One 8:e79988CrossRefPubMedPubMedCentralGoogle Scholar
  10. Charon R (2007) What to do with stories: the sciences of narrative medicine. Can Fam Phys 53:1265–1267Google Scholar
  11. Cowley AW, Cowley T, Norton NJ et al (2009) Foreword. In: Mayer EA, Bushnmell MC (eds) Functional pain syndromes: presentation and pathophysiology. IASP Press, Seattle WAGoogle Scholar
  12. Craig KD (2009) The social communication model of pain. Can Psychol/Psychol Can 50:22–32CrossRefGoogle Scholar
  13. Dezutter J, Luyckx K, Wachholtz A (2015) Meaning in life in chronic pain patients over time: associations with pain experience and psychological well-being. J Behav Med 38:384–396CrossRefPubMedGoogle Scholar
  14. Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar JT, Haythornthwaite JA, Jensen MP, Kerns RD, Ader DN, Brandenburg N, Burke LB, Cella D, Chandler J, Cowan P, Dimitrova R, Dionne R, Hertz S, Jadad AR, Katz NP, Kehlet H, Kramer LD, Manning DC, McCormick C, McDermott MP, McQuay HJ, Patel S, Porter L, Quessy S, Rappaport BA, Rauschkolb C, Revicki DA, Rothman M, Schmader KE, Stacey BR, Stauffer JW, von Stein T, White RE, Witter J, Zavisic S (2008) Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain 9:105–121CrossRefPubMedGoogle Scholar
  15. Edwards RR, Dworkin RD, Sullivan MD, Turk DC, Wsan AD (2016) The role of psychosocial processes in the development and maintenance of chronic pain. J Pain 17(9):T70–T92CrossRefPubMedGoogle Scholar
  16. Edwards I, Jones M, Thacker M, Swisher LL (2014) The moral experience of the patient with chronic pain: bridging the gap between first and third person ethics. Pain Med 15:364–378CrossRefPubMedGoogle Scholar
  17. Finan PH, Garland EL (2015) The role of positive affect in pain and its treatment. Clin Pain 31:177CrossRefGoogle Scholar
  18. Fink SB (2011) Independence and connections of pain and suffering. J Conscious Stud 18:46–66Google Scholar
  19. Frank AW (2015) Asking the right question about pain: narrative and phronesis. Brit J Pain 9:209–225Google Scholar
  20. Garcia-Larrea L, Jackson PL (2016) Pain and the conscious brain. Lippincott Williams and Wilkins, PhiladelphiaGoogle Scholar
  21. Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC (2007) The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull 133:581–624CrossRefPubMedGoogle Scholar
  22. Giordano J (2010) The neuroscience of pain and a neuroethics of pain care. Neuroethics 3:89–94CrossRefGoogle Scholar
  23. Grace V (2003) Embodiment and meaning: understanding chronic pelvic pain. J Conscious Stud 10:41–60Google Scholar
  24. Greenhalgh T, Annandale E, Ashcroft R, Barlow J, Black N, Bleakley A, Boaden R, Braithwaite J, Britten N, Carnevale F, Checkland K, Cheek J, Clark A, Cohn S, Coulehan J, Crabtree B, Cummins S, Davidoff F, Davies H, Dingwall R, Dixon-Woods M, Elwyn G, Engebretsen E, Ferlie E, Fulop N, Gabbay J, Gagnon MP, Galasinski D, Garside R, Gilson L, Griffiths P, Hawe P, Helderman JK, Hodges B, Hunter D, Kearney M, Kitzinger C, Kitzinger J, Kuper A, Kushner S, May AL, Legare F, Lingard L, Locock L, Maben J, Macdonald ME, Mair F, Mannion R, Marshall M, May C, Mays N, McKee L, Miraldo M, Morgan D, Morse J, Nettleton S, Oliver S, Pearce W, Pluye P, Pope C, Robert G, Roberts C, Rodella S, Rycroft-Malone J, Sandelowski M, Shekelle P, Stevenson F, Straus S, Swinglehurst D, Thorne S, Tomson G, Westert G, Wilkinson S, Williams B, Young T, Ziebland S (2016) An open letter to BMJ editors on qualitative research. BMJ 352:i563CrossRefPubMedGoogle Scholar
  25. Gruszczyńska E, Knoll N (2015) Meaning-focused coping, pain, and affect: a diary study of hospitalized women with rheumatoid arthritis. Qual Life Res 24:2873–2883CrossRefPubMedPubMedCentralGoogle Scholar
  26. Hadjistavropoulos T, Craig KD, Duck S, Cano A, Goubert L, Jackson PL, Mogil JS, Rainville P, Sullivan MJ, Williams AC de C, Vervoort T (2011) A biopsychosocial formulation of pain communication. Psychol Bull 137(6):910CrossRefPubMedGoogle Scholar
  27. Hale C, Hadjistavropoulos T (1997) Emotional components of pain. Pain Res Manag 2:217–225CrossRefGoogle Scholar
  28. Hansson KS, Fridlund B, Brunt D, Hansson B, Rask M (2011) The meaning of the experiences of persons with chronic pain in their encounters with the health service. Scand J Car Sci 25(3):444–450CrossRefGoogle Scholar
  29. Head H (1920) Studies in neurology. Oxford University Press, LondonGoogle Scholar
  30. International Association for the Study of Pain (2005) Pain terms. Available via http://www.iasppain.org/terms-p.html#Pain. Accessed 18 Sep 2016 
  31. Jennings R (2013) Meaning of pain for patients with advanced cancer and how it influences behaviour: a qualitative research study. BMJ Supp Palliat Care 3:A67–A67Google Scholar
  32. Jensen MP, Turner JA, Romano JM (2001) Changes in beliefs, catastrophizing, and coping are associated with improvement in multidisciplinary pain treatment. J Consult Clin Psychol 69:655–662CrossRefPubMedGoogle Scholar
  33. Jordan AL, Eccleston C, Osborn M (2007) Being a parent of the adolescent with complex chronic pain: an interpretative phenomenological analysis. Eur J Pain 11(1):49CrossRefPubMedGoogle Scholar
  34. Julien N, Marchand S (2006) Endogenous pain inhibitory systems activated by spatial summation are opioid-mediated. Neurosci Lett 401:256–260CrossRefPubMedGoogle Scholar
  35. Julien N, Goffaux P, Arsenault P, Marchand S (2005) Widespread pain in fibromyalgia is related to a deficit of endogenous pain inhibition. Pain 114:295–302CrossRefPubMedGoogle Scholar
  36. Kerr CE, Shaw JR, Conboy LA, Kelley JM, Jacobson E, Kaptchuk TJ (2011) Placebo acupuncture as a form of ritual touch healing: a neuro-experiential model. Conscious Cogn 20:784–791CrossRefPubMedPubMedCentralGoogle Scholar
  37. Kirwan JR, Minnock P, Adebajo A, Bresnihan B, Choy E, De Wit M, Hazes M, Richards P, Saag K, Suarez-Almazor M, Wells G (2007) Patient perspective: fatigue as a recommended patient centered outcome measure in rheumatoid arthritis. J Rheum 34(5):1174–1177PubMedGoogle Scholar
  38. Landau W, Bishop GH (1953) Pain from dermal, periosteal, and fascial endings and from inflammation: electrophysiological study employing differential nerve blocks. AMA Arch Neurol Psychiatry 69:490–504CrossRefPubMedGoogle Scholar
  39. Lobanov OV, Zeidan F, McHaffie JG, Kraft RA, Coghill RC (2014) From cue to meaning: brain mechanisms supporting the construction of expectations of pain. Pain 155(1):129–136CrossRefPubMedGoogle Scholar
  40. Louw A, Diener I, Butler DS, Puentedura EJ (2011) The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehab 92:2041–2056Google Scholar
  41. McMahon S, Koltzenburg M (2005) Melzack and wall’s textbook of pain, 5th edn. Elsevier/Churchill Livingstone, PhiladelphiaGoogle Scholar
  42. Melzack R (1990) Phantom limbs and the concept of a neuromatrix. Trends Neurosci 13:88–92CrossRefPubMedGoogle Scholar
  43. Melzack R, Casey KL (1968) Sensory, motivational, and central control determinants of pain: a new conceptual model. In: Kenshalo DR (ed) The skin senses. Charles C. Thomas, Springfield, pp 423–443Google Scholar
  44. Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150:971–979CrossRefPubMedGoogle Scholar
  45. Melzack R, Wall PD (1988) The challenge of pain, 2nd edn. Penguin Books, LondonGoogle Scholar
  46. Mendelson G, Mendelson D (2004) Malingering pain in the medicolegal context. Clin J Pain 20:423–432CrossRefPubMedGoogle Scholar
  47. Merskey H (1998) History of pain research and management in Canada. Pain Res Manag 3:164–173CrossRefGoogle Scholar
  48. Mogil JS (2009) Animal models of pain: progress and challenges. Nat Rev Neurosci 10:283–294CrossRefPubMedGoogle Scholar
  49. Moody K, Daswani D, Bess Abrahams RYT, Santizo R (2010) Yoga for pain and anxiety on pediatric hematology-oncology patients: case series and review of the literature. J Soc Integr Oncol 8:95–106Google Scholar
  50. Morley S, Eccleston C, Williams ACDC (1999) Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain 80:1–13CrossRefPubMedGoogle Scholar
  51. Morris DB (1991) The culture of pain. University of California Press, BerkeleyGoogle Scholar
  52. Morris DB (2001) Narrative, ethics, and pain: thinking with stories. Narrative 1:55–77Google Scholar
  53. Morris DB (2010) Sociocultural dimensions of pain management. In: Ballantyne JC, Rathmell JP, Fishman SM (eds) Bonica’s management of pain, 4th edn. Lippincott Williams and Wilkins, New York, pp 133–145Google Scholar
  54. Morris DB (2013) Narrative and pain: towards an integrative model. In: Moore RJ (ed) Handbook of pain and palliative care. Springer, New York, pp 733–751 CrossRefGoogle Scholar
  55. Moseley GL, Arntz A (2007) The context of a noxious stimulus affects the pain it evokes. Pain 133:64–71 Google Scholar
  56. Mountcastle VB (1974) Pain and temperature sensibilities. In: Mountcastle VB (ed) Medical Physiology, 13th edn. Mosby, Saint-Louis, pp 348–381Google Scholar
  57. Nicholas MK, Wilson PH, Goyen J (1992) Comparison of cognitive-behavioral group treatment and an alternative nonpsychological treatment for chronic low back pain. Pain 48:339–347CrossRefPubMedGoogle Scholar
  58. Nijs J, Torres-Cueco R, van Wilgen P, Lluch Girbés E, Struyf F, Roussel N, Van Oosterwijck J, Daenen L, Kuppens K, Vanderweeën L, Hermans L (2014) Applying modern pain neuroscience in clinical practice: criteria for the classification of central sensitization pain. Pain Phys 17:447–457Google Scholar
  59. Osborn M, Rodham K (2010) Insights into pain: a review of qualitative research. Brit J Pain 4:2–7CrossRefGoogle Scholar
  60. Osborn M, Smith JA (2006) Living with a body separate from the self. The experience of the body in chronic benign low back pain: an interpretative phenomenological analysis. Scand J Care Sci 20:216–222CrossRefGoogle Scholar
  61. Osborn M, Smith JA (2015) The personal experience of chronic benign lower back pain: an interpretative phenomenological analysis. Brit J Pain 9:65–83CrossRefGoogle Scholar
  62. O’Brien EM, Staud RM, Hassinger AD, McCulloch RC, Craggs JG, Atchison JW, Price DD, Robinson ME (2010) Patient-centered perspective on treatment outcomes in chronic pain. Pain Med 11:6–15CrossRefPubMedGoogle Scholar
  63. Price DD (1972) Characteristics of second pain and flexion reflexes indicative of prolonged central summation. Exp Neurol 37:371–387CrossRefPubMedGoogle Scholar
  64. Price DD (1988) Psychological and neural mechanisms of pain. Raven Press, New YorkGoogle Scholar
  65. Price DD (1999) Psychological mechanisms of pain and analgesia. IASP Press, SeattleGoogle Scholar
  66. Price DD (2000) Psychological and neural mechanisms of the affective dimension of pain. Science 288:1769–1772CrossRefPubMedGoogle Scholar
  67. Price DD, Aydede M (2006) The experimental use of introspection in the scientific study of pain and its integration with third-person methodologies: the experiential–phenomenological  approach. In: Aydede M (ed) Pain: new essays on its nature and the methodology of its study. MIT Press, Cambridge, pp 243–273Google Scholar
  68. Price DD, Barrell JJ (2012) Inner experiences and neuroscience. Merging the two perspectives. MIT Press, CambridgeGoogle Scholar
  69. Price DD, Barrell JJ, Rainville P (2002) Integrating experiential–phenomenological methods and neuroscience to study neural mechanisms of pain and consciousness. Conscious Cogn 11:593–608CrossRefPubMedGoogle Scholar
  70. Price DD, Harkin SW, Baker C (1987) Sensory affective relationships among different types of clinical and experimental pain. Pain 28:291–299CrossRefGoogle Scholar
  71. Price DD, Hu JW, Dubner R, Gracely RH (1977) Peripheral suppression of first pain and central summation of second pain evoked by noxious heat pulses. Pain 3:57–68CrossRefPubMedGoogle Scholar
  72. Rainville P, Price DD (2004) The experiential neuroscience of hypnosis and hypnotic analgesia. Psychological methods of pain control: basic science and clinical perspectives. Prog Pain Res Manag 29:235–267Google Scholar
  73. Rubins JL, Friedman ED (1948) Asymbolia for pain. Neurol Psychol 60:554–560CrossRefGoogle Scholar
  74. Smith JA (1996) Beyond the divide between cognition and discourse: using interpretative phenomenological analysis in health psychology. Psychol Health 11:261–271CrossRefGoogle Scholar
  75. Smith JA, Flowers P, Larkin M (2009) Interpretative phenomenological analysis: theory, methods and research. Sage Publications, LondonGoogle Scholar
  76. Smith JA, Osborn M (2007) Pain as an assault on the self: an interpretative phenomenological analysis of the psychological impact of chronic benign low back pain. Psychol Health 22:517–534CrossRefGoogle Scholar
  77. Smith JA, Osborn M (2014) Interpretative phenomenological analysis as a useful methodology for research on the lived experience of pain. Brit J Pain 28:1–2Google Scholar
  78. Snelgrove S, Edwards S, Liossi C (2013) A longitudinal study of patients’ experiences of chronic low back pain using interpretative phenomenological analysis: changes and consistencies. Psychol Health 28(2):121–138CrossRefPubMedGoogle Scholar
  79. Snow R, Crocker J, Talbot K, Moore J, Salisbury H (2016) Does hearing the patient perspective improve consultation skills in examinations? An exploratory randomized controlled trial in medical undergraduate education. Med Educ. doi: 10.1080/0142159X.2016.1210109 Google Scholar
  80. Staud R, Craggs JG, Perlstein WM, Robinson ME, Price DD (2008) Brain activity associated with slow temporal summation of C-fiber evoked pain in fibromyalgia patients and healthy controls. Eur J Pain 12(8):1078–1089CrossRefPubMedPubMedCentralGoogle Scholar
  81. Staud R, Vierck CJ, Cannon RL, Mauderli AP, Price DD (2001) Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain 91:165–175CrossRefPubMedGoogle Scholar
  82. Sternback RA (1968) Pain: a psychophysiological analysis. Academic Press, New YorkGoogle Scholar
  83. Tabor A, Catley MJ, Gandevia S, Thacker MA, Moseley GL (2013) Perceptual bias in pain: a switch looks closer when it will relieve pain than when it won’t. Pain 154(10):1961–1965CrossRefPubMedGoogle Scholar
  84. Teh CF, Karp JF, Kleinman A, Reynolds CF III, Weiner DK, Cleary PD (2009) Older people’s experiences of patient-centered treatment for chronic pain: a qualitative study. Pain Med 10(3):521–530CrossRefPubMedPubMedCentralGoogle Scholar
  85. Thacker MA, Moseley GL (2012) First-person neuroscience and the understanding of pain. Med J Aust 196(6):410–411Google Scholar
  86. Thorne S, ReimerKirkham S, MacDonald-Emes J (1997) Interpretive description: a noncategorical qualitative alternative for developing nursing knowledge. Res Nurs Health 20:169–177CrossRefPubMedGoogle Scholar
  87. Toye F, Williamson E, Williams MA, Fairbank J, Lamb SE (2016) What value can qualitative research add to quantitative research design? An example from an adolescent idiopathic scoliosis trial feasibility study. Qual Health Res. doi: 10.1177/1049732316662446 PubMedGoogle Scholar
  88. Tracey I, Mantyh PW (2007) The cerebral signature for pain perception and its modulation. Neuron 55(3):377–391CrossRefPubMedGoogle Scholar
  89. van Rysewyk S (2014) Objective knowledge of subjective pain? Towards a subjective-neuroscience of pain. Ngau Mamae, Spring, pp 10–20Google Scholar
  90. Valenzuela-Moguillansky C (2013) Pain and body awareness. An exploration of the bodily experience of persons suffering from fibromyalgia. Constructivist Foundations 8(3):339–350Google Scholar
  91. Varela FJ (1996) Neurophenomenology: a methodological remedy to the hard problem. J Conscious Stud 3:330–350Google Scholar
  92. Vlaeyen JWS, Morley S, Crombez G (2016) The experimental analysis of the interruptive, interfering, and identity-distorting effects of chronic pain. Behav Res Ther. doi: 10.1016/j.brat.2016.08.016 Google Scholar
  93. Wager TD, Atlas LY, Lindquist MA, Roy M, Woo CW, Kross E (2013) An fMRI-based neurologic signature of physical pain. N Eng J Med 368:1388–1397CrossRefGoogle Scholar
  94. Walsh DA, Kelly SJ, Johnson PS, Rajkumar S, Bennetts K (2004) Performance problems of patients with chronic low-back pain and the measurement of patient-centered outcome. Spine 29:87–93CrossRefGoogle Scholar
  95. Werner A, Malterud K (2003) It is hard work behaving as a credible patient: encounters between women with chronic pain and their doctors. Soc Sci Med 57:1409–1419CrossRefPubMedGoogle Scholar
  96. Williams ACDC, Davies HTO, Chadury Y (2000) Simple pain rating scales hide complex idiosyncratic meanings. Pain 85:457–463CrossRefGoogle Scholar

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© Springer International Publishing AG 2016

Authors and Affiliations

  1. 1.School of Humanities, Department of Philosophy and Gender StudiesUniversity of TasmaniaTasmaniaAustralia

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