It’s been a long time since I posted anything on this blog. I had a good reason (past tense, of course). I began developing a course to help people treat or manage their own pain. A considerable project I intended to present as a series of episodes via this blog. But (there’s often a ‘but’) this project was abandoned, temporarily I want to add, in favour of other interests. In particular, the IASP (the International Association for the Study of Pain) published a new definition of pain. If you’ve read my previous posts you’ll know that the old (and original) definition was a hobbyhorse of mine. While the publication of a new definition wasn’t completely unexpected (the IASP released a revision for comment in 2019), its wording was surprising. One of the problems of the old version was its opacity, but the new version is no clearer than the old. I’ll blog about the new version in the near future. Thoughts about the new definition inspired me to resurrect another old hobbyhorse, the nociceptive system; the concept of a sensory system specifically adapted to discriminate noxious energy. I’ve now finished a paper (as yet unpublished) in which I argue there’s no such thing. Oh, and I’ve moved house. All of this is an excuse, but it’s also an introduction to the topic of this post (except the house bit) – the conceptual model that scientists use to frame experimental data (the definition of pain and the nociceptive system are aspects of this model).
A few days ago I listened to a podcast on the IASP’s Pain Research Forum website. Ostensibly, the discussion was about the encoding of sensory information; is this information preserved by specific neural pathways (by so-called ‘labelled lines’) or is it encoded in patterns of neurological activity. It’s widely accepted that this is not an either/or debate, that both are aspects of pain system neurology. But the contributors (all experts in the field) went further than this. One questioned whether the debate mattered. And all bemoaned existing theoretical models. It was quite anarchic and rather refreshing.
From the standpoint of someone who bats on about the inadequacy of theoretical models of pain (myself) the most telling comment was (to paraphrase) ‘Should we bin our theoretical models and just listen to the data.’ But we can’t just listen to the data. It would be like listening to a completely unfamiliar language. A conceptual framework is necessary to make sense of scientific data. It would be charitable to say that the contributors really mean that current theoretical models are inadequate, but the discussion suggested otherwise. Instead of urging conceptual review and revision, they seem to see the production of more data as the solution, but it isn’t a solution. To a certain extent this is understandable, data production is what they know best. But it is no excuse. While the contributors recognise the problem they don’t seem to see the obvious solution: more and better pain research. Unfortunately, unless conceptual research has greater prestige and attracts a level of funding that reflects its actual importance this situation is unlikely to change significantly. Ten years from now I can see the same contributors having a similar discussion and bemoaning the adequacy of theoretical models. Maybe then, as representatives of the pain science community generally, they’ll understand that more pain data is not a solution.
The Pain Jam 