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Congenital Insensitivity to Pain: A Misnomer

  • Asaf Weisman
    Correspondence
    Address reprint requests to Asaf Weisman, Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    Affiliations
    Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel

    Clalit Health Services, Department of Physical Therapy, Holon, Israel
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  • John Quintner
    Affiliations
    Arthritis Foundation of Western Australia, Shenton Park WA, Australia
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  • Youssef Masharawi
    Affiliations
    Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
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Published:February 01, 2019DOI:https://doi.org/10.1016/j.jpain.2019.01.331

      Highlights

      • The term congenital insensitivity to pain is epistemologically incorrect.
      • Congenital insensitivity to pain conflates pain and nociception.
      • The term is outdated and the product of historical circumstances.
      • A more accurate term is needed to study and understand the conditions.
      • Congenital nociceptor deficiency better reflects the nature of the conditions.

      Abstract

      Congenital insensitivity to pain is an umbrella term used to describe a group of rare genetic diseases also classified as hereditary sensory autonomic neuropathies. These conditions are intriguing, with the potential to shed light on the poorly understood relationship concerning nociception and the experience of pain. However, the term congenital insensitivity to pain is epistemologically incorrect and is the product of historical circumstances. The term conflates pain and nociception and, thus, prevents researchers and caregivers from grasping the full dimensions of these conditions. The aims of this article were to review the epistemological problems surrounding the term, to demonstrate why the term is inaccurate and to suggest a new term, namely, congenital nociceptor deficiency. The suggested term better reflects the nature of the conditions and incorporates current understandings of nociception.

      Perspective

      The umbrella term congenital insensitivity to pain conflates pain and nociception, which is epistemologically unacceptable. We suggest a new term, namely, congenital nociceptor deficiency, that overcomes this problem and is concordant with current neurobiological knowledge.

      Key words

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