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Suggested Citation:"Glossary." Institute of Medicine. 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press. doi: 10.17226/13172.
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Glossary

Acute pain: Pain that comes on quickly, can be severe, but lasts a relatively short time. (1)1

Addiction: A primary, chronic, neurobiologic disease whose development and manifestations are influenced by genetic, psychosocial, and environmental factors. It is characterized by behavior that includes one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving. (2)

Allodynia: Pain due to a stimulus that does not normally provoke pain. (3)

Allostatic load: The cumulative physiological cost to the body of chronic exposure to the stress response. (4)

Analgesia: Absence of pain in response to a stimulus that would normally be painful. (5)

Beliefs: Assumptions about reality that shape the interpretation of events and, consequently, the appraisal of pain. (6)

Biopsychosocial model: A framework that accounts for the biological, psychological, and social dimensions of illness and disease. The biopsychosocial model

________________

1 Numbers in parentheses indicate the respective references listed at the end of this glossary.

Suggested Citation:"Glossary." Institute of Medicine. 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press. doi: 10.17226/13172.
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provides a basis for the understanding and treatment of disease, taking into account the patient, his/her social context, and the impact of illness on that individual from a societal perspective. The model states that ill health and disease are the result of interaction among biological, psychological, and social factors. (7)

Chronic pain: Ongoing or recurrent pain lasting beyond the usual course of acute illness or injury or, generally, more than 3 to 6 months and adversely affecting the individual’s well-being. A simpler definition for chronic or persistent pain is pain that continues when it should not. (8)

Cognitive-behavioral therapy: An empirically supported treatment focusing on patterns of thinking that are maladaptive and the beliefs that underlie such thinking. Cognitive-behavioral therapy is based on the idea that our thoughts, not external factors, such as people, situations, and events, cause our feelings and behavior. As a result, we can change the way we think to improve the way we feel, even if the situation does not change. (9)

Hyperalgesia: Increased pain from a stimulus that normally provokes pain. (10)

Interdisciplinary: Refers to efforts in which professionals from several disciplines combine their professional expertise and understanding to solve a problem.

Neuromatrix theory: Proposes that pain is a multidimensional experience produced by characteristic “neurosignature” patterns of nerve impulses generated by a widely distributed neural network—the “body-self neuromatrix”—in the brain. These neurosignature patterns may be triggered by sensory inputs, but they may also be generated independently of them. (11)

Neuropathic pain: Pain caused by a lesion or disease of the somatosensory nervous system. (12)

Nociception: The neural processes of encoding and processing noxious stimuli. (13)

Opioid: Any compound that binds to an opioid receptor. Includes the opioid drugs (agonist analgesics and antagonists) and the endogenous opioid peptides. (14)

Pain: An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. (15)

Pain catastrophizing: An individual’s tendency to focus on and exaggerate the threat value of painful stimuli and negatively evaluate his/her ability to deal with pain. (16)

Suggested Citation:"Glossary." Institute of Medicine. 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press. doi: 10.17226/13172.
×

Referred pain: Pain subjectively localized in one region although due to irritation in another. (17)

Self-efficacy: Beliefs that individuals hold about their capability to carry out actions in a way that will influence the events that affect their lives. (18)

Sensitization: An increased response of neurons to a variety of inputs following intense or noxious stimuli. (19)

REFERENCES

(1)  American Chronic Pain Association. 2011. Glossary. http://www.theacpa.org/30/Glossary.aspx (accessed June 9, 2011).

(2)  APS (American Pain Society). 2001. Definitions related to the use of opioids for the treatment of pain. http://www.ampainsoc.org/advocacy/opioids2.htm (accessed April 25, 2011).

(3)  IASP (International Association for the Study of Pain). 2011. Pain terms. http://www.iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.cfm&ContentID=1728#Allodynia (accessed June 9, 2011).

(4)  NIAAA (National Institute on Alcohol Abuse and Alcoholism). 2011. Glossary. http://pubs.niaaa.nih.gov/publications/arh312/177-179.pdf (accessed April 25, 2011).

(5)  IASP (International Association for the Study of Pain). 2011. Pain terms. http://www.iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.cfm&ContentID=1728#Analgesia (accessed June 9, 2011).

(6)  Gatchel, R. J., Y. B. Peng, M. L. Peters, P. N. Fuchs, and D. C. Turk. 2007. The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin 133(4):581-624.

(7)  Brown, B. T., R. Bonello, and H. Pollard. 2005. The biopsychosocial model and hypothyroidism. Chiropractic and Osteopathy 13(1):5.

(8)  American Chronic Pain Association. 2011. Glossary. http://www.theacpa.org/30/Glossary.aspx (accessed June 9, 2011).

(9)  (a) NAMI (National Alliance on Mental Illness). 2011. Treatment and services—cognitive-behavioral therapy. http://www.nami.org/Template.cfm?Section=About_Treatments_and_Supports&template=/ContentManagement/ContentDisplay.cfm&ContentID=7952 (accessed May 4, 2011).

(b) NACBT (National Association of Cognitive-Behavioral Therapists). 2011. Cognitive-behavioral therapy. http://www.nacbt.org/whatiscbt.htm (accessed May 4, 2011).

(10)  IASP (International Association for the Study of Pain). 2011. Pain terms. http://www.iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.cfm&ContentID=1728#Hyperalgesia (accessed June 9, 2011).

(11)  Melzack, R. 2005. Evolution of the neuromatrix theory of pain. The Prithvi Raj Lecture: Presented at the Third World Congress of World Institute of Pain, Barcelona 2004. Pain Practice 5(2):85-94.

(12)  IASP (International Association for the Study of Pain). 2011. Pain terms. http://www.iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.cfm&ContentID=1728#Neuropathicpain (accessed June 9, 2011).

(13)  Loeser, J. D., and R. D. Treede. 2008. The Kyoto protocol of IASP basic pain terminology. Pain 137(3):473-477.

(14)  Katzung, B., A. Trevor, and S. Masters. 2009. Opiod analgesics & antagonists. In Basic and clinical pharmacology, 11th ed. McGraw-Hill Companies, Inc.

Suggested Citation:"Glossary." Institute of Medicine. 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press. doi: 10.17226/13172.
×

(15)  IASP (International Association for the Study of Pain). 2011. Pain terms. http://www.iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.cfm&ContentID=1728#Pain (accessed June 9, 2011).

(16)  (a) F. J. Keefe, J. C Lefebvre, J. R. Egert, G. Affleck, M. J. Sullivan, and D. S. Caldwell. 2000. The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: The role of catastrophizing. Pain 87(3):325-334.

(b) Rosenstiel, A. K., and F. J. Keefe. 1983. The use of coping strategies in chronic low back pain patients: Relationship to patient characteristics and current adjustment. Pain 17(1):33-44.

(c) Keefe, F. J., G. K. Brown, K. A. Wallston, and D. S. Caldwell. 1989. Coping with rheumatoid arthritis pain: Catastrophizing as a maladaptive strategy. Pain 37(1):51-56.

(d) Sullivan, M. J. L., S. Bishop, and J. Pivik. 1995. The pain catastrophizing scale: Development and validation. Psychological Assessment 7(4):524-532.

(17)  MedlinePlus. 2011. Referred pain. http://www.merriam-webster.com/medlineplus/referredpain (accessed April 25, 2011).

(18)  Smith, B. J., K. C. Tang, and D. Nutbeam. 2006. WHO health promotion glossary: New terms. Health Promotion International 21(4):340-345.

(19)  Baranauskas, G., and A. Nistri. 1998. Sensitization of pain pathways in the spinal cord: Cellular mechanisms. Progress in Neurobiology 54(3):349-365.

Suggested Citation:"Glossary." Institute of Medicine. 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press. doi: 10.17226/13172.
×
Page277
Suggested Citation:"Glossary." Institute of Medicine. 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press. doi: 10.17226/13172.
×
Page278
Suggested Citation:"Glossary." Institute of Medicine. 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press. doi: 10.17226/13172.
×
Page279
Suggested Citation:"Glossary." Institute of Medicine. 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: The National Academies Press. doi: 10.17226/13172.
×
Page280
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Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem.

In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.

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