Pain Research

Last updated: Fri, Feb 21, 2025

Scientific Research

The limitations of pain measurement combine with other limitations of scientific method and practice to limit and channel scientific research into pain. The corpus of reliable, verifiable knowledge we have about pain is a direct result of these limitations. This section describes methods used in pain research and some of the limitations to its inferential power. This perspective on the pain problem is important to understanding the limits of our understanding of pain. It should qualify all claims that understandings or medical approaches are "scientific."

Scientific research into pain is limited by a number of factors, including the nature of pain itself. For this reason, a look at pain research is worthwhile.

Pain-related research seems to separate into four major clusters.

• Epidemiological research into pain uses statistical techniques to estimate the size of the pain problem and to look for clues into causes. A lack of clear and easily-understood definitions and markers makes it difficult to identify those who suffer from specific pain syndromes. Because of expense and other practical limitations of the methodology, epidemiology is much more productive in identifying factors associated with pain than in determining the nature of the associations. (Epidemiology.)
• Physiological research into pain is both sophisticated and expensive. It deals with the cellular, sub-cellular, and super-cellular mechanisms by which our pain systems operate. It is motivated largely by the desire to find medical interventions for pain problems, including but not limited to the search for pharmaceutical interventions. It is difficult to tie physiological findings to the experience of pain in part because the experience of pain emerges at a great remove from the locus of much physiological research. The gap between physiological and behavioral views of pain is evident in the lack of comparability between models used in the physiological and behavioral views of pain. However, findings from this research are informing and modifying the clinical and popular views of pain, and are likely to continue to do so. Behavioral models will change as a result. (Physiological Research.)
• Behavioral research into pain is firmly embedded into the concepts and practices of the cognitive-behavioral model of pain. Although there is much of this research, it tends to be tautological, as will be described later (see Pyschological/Behavioral Research).
• Non-medical laboratory research into pain is relatively inexpensive and is capable of establishing confident results in model-independent fashion. This laboratory research, however, has limitations that affect its generalizability and extensibility. It is not possible to create realistic models of many aspects of pain in a laboratory. From the perspective of chronic pain problems, laboratory research has resulted in a vast overemphasis on acute, intermittent, safe, cutaneous pain scenarios in human research. (The Psychology of Pain.)

Pain research is of course not value-neutral, and the agenda of research is set by people with normal human perspectives. Dr. J. E. Sarno, whose perspective on pain is examined in Freudian Theories made this remark in one of his books:

This question [whether psychosomatically-caused hypertension should be treated differently] has been the subject of virtually no research and is not even on the radarscope of researchers, probably because medical researchers are not interested in psychology and research psychologists are not interested in antihypertensive medications.1

Scientific research tends to follow established patterns, which were named "paradigms" by Thomas Kuhn in his classic essay, The Structure of Scientific Revolutions.

Medical Research

Medical research is oriented toward pathologies and treatments and tends to dovetail with the organization of medical care. Certainly it's better to have some help than no help, and if I have to endure some of the trappings of patienthood to get help, I will. But it is worthwhile to consider how well our needs as pain-disabled individuals are met by the medical model, whether we have needs that are un-met, and whether in fact they are first doing no harm. My major discussion of these issues is in The Experience of Chronic Pain, after I've presented more background, but here I'd like to point out what may be an issue with applying the medical model to pain research.

The idea of pathology (illness) is deeply-engrained in medical thinking. We become entitled to medical help by illness, not merely by having big problems. Treatment is directed at correcting the pathology, and in fact it is the pathology that is treated. In chronic pain we have, whether or not it is a pathology, a condition for which the treatments are mostly palliative and are mostly not very effective. It is a condition that is more likely to become worse than to go away.

At the same time, chronic pain is a condition that has serious, diffuse effects throughout all the aspects of a person's life, physical, emotional, social, economical, artistic, intellectual. How effective is a medical viewpoint that focusses on a basically untreatable pathology in improving the life prospects ot chronic pain's victims? And how effective is a treatment perspective that focuses on the patient in dealing with a condition whose most severe consequences are often social ones?

See The Challenge of Living in Pain for a perspective on what is the real damage caused by chronic pain. See Psychological and Psychiatric Treatments and Medical Pain Treatment for more on the fit between the needs of chronic pain patients and our sole system for delivering help to them.

Within this section...

Methods of Study (Last updated: Fri, Jun 30, 2017)

Human Pain Experimentation (This page is incomplete.)

Regression to the Mean and the Placebo Effect (Last updated: Fri, Feb 21, 2025)

Limits to Understanding (Last updated: Mon, Jul 29, 2024)

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The Psychology of Pain (Last updated: Mon, Nov 18, 2024)