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Comment & Response
December 2014

Pain Terminology

Author Affiliations
  • 1Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
  • 2Perelman School of Medicine at the University of Pennsylvania, Philadelphia
JAMA Pediatr. 2014;168(12):1167-1168. doi:10.1001/jamapediatrics.2014.1784

To the Editor I concur with Dr Schechter’s appeal recently published in JAMA Pediatrics to discontinue the use of the term functional pain but find his proposed new term, primary pain disorder, equally unsatisfying.1 It is akin to telling someone with a fast heart rate they have tachycardia. Although he dismisses the term amplified pain, interpreted by patients as implying they are amplifying or exaggerating their pain, it is not so interpreted by my patients. Strumming a guitar string is a rather quiet sound; however, if that sound is run through an amplifier it can become exceedingly and even painfully loud. Likewise, normal body sensations can be amplified to the point of extreme pain. The fact that the body is amplifying the sensation does not imply malingering or hyperbola. It allows a patient with allodynia to understand why a light touch can be so painful and why medications are not helpful.2Amplified pain syndrome, like any other medical term, needs to be explained in such a fashion that the patient can understand it. In my experience, it is helpful and better than telling someone who is in pain that he or she has pain.

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