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75-745: The Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (commonly known as the United Nations Convention Against Torture ( UNCAT )) is an international human rights treaty under the review of the United Nations that aims to prevent torture and other acts of cruel, inhuman, or degrading treatment or punishment around the world. The Convention requires member states to take effective measures to prevent torture in any territory under their jurisdiction , and forbids member states to transport people to any country where there

150-486: A decreased appetite and decreased nutritional intake. A change in condition that deviates from baseline, such as moaning with movement or when manipulating a body part, and limited range of motion are also potential pain indicators. In patients who possess language but are incapable of expressing themselves effectively, such as those with dementia, an increase in confusion or display of aggressive behaviors or agitation may signal that discomfort exists, and further assessment

225-488: A credible and convincing signal of the need for relief, help, and care. Idiopathic pain (pain that persists after the trauma or pathology has healed, or that arises without any apparent cause) may be an exception to the idea that pain is helpful to survival, although some psychodynamic psychologists argue that such pain is psychogenic, enlisted as a protective distraction to keep dangerous emotions unconscious. In pain science, thresholds are measured by gradually increasing

300-399: A definition of torture (Article 1), and commits parties to taking effective measures to prevent any act of torture in any territory under their jurisdiction (Article 2). These include ensuring that torture is a criminal offense under a party's municipal law (Article 4), establishing jurisdiction over acts of torture committed by or against a party's nationals (Article 5), ensuring that torture

375-525: A higher risk of being stigmatized, leading to less urgent treatment of women based on social expectations of their ability to accurately report it. This has been postulated to lead to extended emergency room wait times for women and frequent dismissal of their ability to accurately report pain. Pain is a symptom of many medical conditions. Knowing the time of onset, location, intensity, pattern of occurrence (continuous, intermittent, etc.), exacerbating and relieving factors, and quality (burning, sharp, etc.) of

450-687: A means to protect public safety or prevent emergencies. Subordinates who commit acts of torture cannot abstain themselves from legal responsibility on the grounds that they were just following orders from their superiors . The prohibition on torture applies to anywhere under a party's effective jurisdiction inside or outside of its borders, whether on board its ships or aircraft or in its military occupations , military bases , peacekeeping operations , health care industries , schools , day care centers , detention centers , embassies , or any other of its areas, and protects all people under its effective control, regardless of nationality or how that control

525-454: A non-communicative person, observation becomes critical, and specific behaviors can be monitored as pain indicators. Behaviors such as facial grimacing and guarding (trying to protect part of the body from being bumped or touched) indicate pain, as well as an increase or decrease in vocalizations, changes in routine behavior patterns and mental status changes. Patients experiencing pain may exhibit withdrawn social behavior and possibly experience

600-489: A particular legal system and what are not. The drafters of the Convention neither provided any criteria for making such determination nor did it define the terms. The nature of the findings would so differ from one legal system to another that they would give rise to serious disputes among the parties to the convention. It was suggested that the reference to such rules would make the issue more complicated, for it would endow

675-577: A person's quality of life and general functioning. People in pain experience impaired concentration, working memory , mental flexibility , problem solving and information processing speed, and are more likely to experience irritability, depression, and anxiety. Simple pain medications are useful in 20% to 70% of cases. Psychological factors such as social support , cognitive behavioral therapy , excitement, or distraction can affect pain's intensity or unpleasantness. First attested in English in 1297,

750-582: A principle of customary international law . As of April 2024, the convention has 174 state parties. The Convention follows the structure of the Universal Declaration of Human Rights (UDHR), International Covenant on Civil and Political Rights (ICCPR) and the International Covenant on Economic, Social and Cultural Rights (ICESCR), with a preamble and 33 articles, divided into three parts: Part I (Articles 1–16) contains

825-556: A reduction in negative affect . Across studies, participants that were subjected to acute physical pain in the laboratory subsequently reported feeling better than those in non-painful control conditions, a finding which was also reflected in physiological parameters. A potential mechanism to explain this effect is provided by the opponent-process theory . Before the relatively recent discovery of neurons and their role in pain, various body functions were proposed to account for pain. There were several competing early theories of pain among

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900-790: A report within one year, after which they are obliged to report every four years. The Committee examines each report and addresses its concerns and recommendations to the State party in the form of "concluding observations". Under certain circumstances, the CAT may consider complaints or communications from individuals claiming that their rights under the Convention have been violated. The CAT usually meets in April/May and November each year in Geneva . Members are elected to four-year terms by State parties and can be re-elected if nominated. The current membership of

975-707: A result of decreased sensation. A much smaller number of people are insensitive to pain due to an inborn abnormality of the nervous system, known as " congenital insensitivity to pain ". Children with this condition incur carelessly-repeated damage to their tongues, eyes, joints, skin, and muscles. Some die before adulthood, and others have a reduced life expectancy. Most people with congenital insensitivity to pain have one of five hereditary sensory and autonomic neuropathies (which includes familial dysautonomia and congenital insensitivity to pain with anhidrosis ). These conditions feature decreased sensitivity to pain together with other neurological abnormalities, particularly of

1050-448: A state known as pain asymbolia, described as intense pain devoid of unpleasantness, with morphine injection or psychosurgery . Such patients report that they have pain but are not bothered by it; they recognize the sensation of pain but suffer little, or not at all. Indifference to pain can also rarely be present from birth; these people have normal nerves on medical investigations, and find pain unpleasant, but do not avoid repetition of

1125-432: Is "pain that extends beyond the expected period of healing". Chronic pain may be classified as " cancer-related " or "benign." Allodynia is pain experienced in response to a normally painless stimulus. It has no biological function and is classified by characteristics of the stimuli as cold, heat, touch, pressure or a pinprick. Phantom pain is pain felt in a part of the body that has been amputated , or from which

1200-701: Is a common, reproducible tool in the assessment of pain and pain relief. The scale is a continuous line anchored by verbal descriptors, one for each extreme of pain where a higher score indicates greater pain intensity. It is usually 10 cm in length with no intermediate descriptors as to avoid marking of scores around a preferred numeric value. When applied as a pain descriptor, these anchors are often 'no pain' and 'worst imaginable pain". Cut-offs for pain classification have been recommended as no pain (0–4mm), mild pain (5–44mm), moderate pain (45–74mm) and severe pain (75–100mm). The Multidimensional Pain Inventory (MPI)

1275-483: Is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage." Pain motivates organisms to withdraw from damaging situations, to protect a damaged body part while it heals, and to avoid similar experiences in

1350-496: Is a questionnaire designed to assess the psychosocial state of a person with chronic pain. Combining the MPI characterization of the person with their IASP five-category pain profile is recommended for deriving the most useful case description. Non-verbal people cannot use words to tell others that they are experiencing pain. However, they may be able to communicate through other means, such as blinking, pointing, or nodding. With

1425-475: Is also associated with increased depression, anxiety, fear, and anger. If I have matters right, the consequences of pain will include direct physical distress, unemployment, financial difficulties, marital disharmony, and difficulties in concentration and attention… Although pain is considered to be aversive and unpleasant and is therefore usually avoided, a meta-analysis which summarized and evaluated numerous studies from various psychological disciplines, found

1500-432: Is an extraditable offense (Article 8), and establishing universal jurisdiction to bring cases of torture to trial where an alleged torturer cannot be extradited (Article 5). Parties must promptly investigate any allegation of torture (Articles 12 and 13), and victims of torture, or their dependents in case victims died as a result of torture, must have an enforceable right to compensation (Article 14). Parties must also ban

1575-547: Is distinctly located also activates the primary and secondary somatosensory cortex . Spinal cord fibers dedicated to carrying A-delta fiber pain signals and others that carry both A-delta and C fiber pain signals to the thalamus have been identified. Other spinal cord fibers, known as wide dynamic range neurons , respond to A-delta and C fibers and the much larger, more heavily myelinated A-beta fibers that carry touch, pressure, and vibration signals. Ronald Melzack and Patrick Wall introduced their gate control theory in

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1650-474: Is essential for protection from injury, and recognition of the presence of injury. Episodic analgesia may occur under special circumstances, such as in the excitement of sport or war: a soldier on the battlefield may feel no pain for many hours from a traumatic amputation or other severe injury. Although unpleasantness is an essential part of the IASP definition of pain, it is possible in some patients to induce

1725-478: Is exercised. The other articles of part I lay out specific obligations intended to implement this absolute prohibition by preventing, investigating, and punishing acts of torture. Article 3 prohibits parties from returning, extraditing, or refouling any person to a state "where there are substantial grounds for believing that he would be in danger of being subjected to torture." The Committee Against Torture has held that this danger must be assessed not just for

1800-403: Is initially described as burning or tingling but may evolve into severe crushing or pinching pain, or the sensation of fire running down the legs or of a knife twisting in the flesh. Onset may be immediate or may not occur until years after the disabling injury. Surgical treatment rarely provides lasting relief. Breakthrough pain is transitory pain that comes on suddenly and is not alleviated by

1875-413: Is intentionally inflicted on a person for such purposes as obtaining from him, or a third person, information or a confession , punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with

1950-507: Is necessary. Changes in behavior may be noticed by caregivers who are familiar with the person's normal behavior. Infants do feel pain , but lack the language needed to report it, and so communicate distress by crying. A non-verbal pain assessment should be conducted involving the parents, who will notice changes in the infant which may not be obvious to the health care provider. Pre-term babies are more sensitive to painful stimuli than those carried to full term. Another approach, when pain

2025-421: Is often described as shooting, crushing, burning or cramping. If the pain is continuous for a long period, parts of the intact body may become sensitized, so that touching them evokes pain in the phantom limb. Phantom limb pain may accompany urination or defecation . Local anesthetic injections into the nerves or sensitive areas of the stump may relieve pain for days, weeks, or sometimes permanently, despite

2100-597: Is often difficult to distinguish between cruel, inhuman, or degrading treatment or punishment and torture, the Committee regards Article 16's prohibition of such act as similarly absolute and non-derogable. As of 17 November 2021, there are 173 States parties. 22 UN Member States are not yet party to the convention. The Optional Protocol to the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT), adopted by

2175-735: Is reason to believe they will be tortured. The text of the convention was adopted by the United Nations General Assembly on 10 December 1984 and, following ratification by the 20th state party, it came into force on 26 June 1987. 26 June is now recognized as the International Day in Support of Victims of Torture , in honor of the convention. Since the convention's entry was enforced, the absolute prohibition against torture and other acts of cruel, inhuman, or degrading treatment or punishment has become accepted as

2250-412: Is suspected, is to give the person treatment for pain, and then watch to see whether the suspected indicators of pain subside. The way in which one experiences and responds to pain is related to sociocultural characteristics, such as gender, ethnicity, and age. An aging adult may not respond to pain in the same way that a younger person might. Their ability to recognize pain may be blunted by illness or

2325-729: The International Covenant on Civil and Political Rights , and the International Covenant on Economic, Social and Cultural Rights together with other international human rights instruments are sometimes referred to as the " International Bill of Human Rights ". International human rights instruments are identified by the OHCHR and most are referenced on the OHCHR website. According to OHCHR, there are 9 core international human rights instruments and several optional protocols. Several more human rights instruments exist. A few examples: Pain Pain

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2400-527: The autonomic nervous system . A very rare syndrome with isolated congenital insensitivity to pain has been linked with mutations in the SCN9A gene, which codes for a sodium channel ( Na v 1.7 ) necessary in conducting pain nerve stimuli. Experimental subjects challenged by acute pain and patients in chronic pain experience impairments in attention control, working memory capacity , mental flexibility , problem solving, and information processing speed. Pain

2475-405: The medial , paleospinothalamic tract . The neospinothalamic tract carries the fast, sharp A-delta signal to the ventral posterolateral nucleus of the thalamus . The paleospinothalamic tract carries the slow, dull C fiber pain signal. Some of the paleospinothalamic fibers peel off in the brain stem—connecting with the reticular formation or midbrain periaqueductal gray—and the remainder terminate in

2550-473: The 1965 Science article "Pain Mechanisms: A New Theory". The authors proposed that the thin C and A-delta (pain) and large diameter A-beta (touch, pressure, vibration) nerve fibers carry information from the site of injury to two destinations in the dorsal horn of the spinal cord, and that A-beta fiber signals acting on inhibitory cells in the dorsal horn can reduce the intensity of pain signals sent to

2625-447: The 19th-century development of specificity theory . Specificity theory saw pain as "a specific sensation, with its own sensory apparatus independent of touch and other senses". Another theory that came to prominence in the 18th and 19th centuries was intensive theory , which conceived of pain not as a unique sensory modality, but an emotional state produced by stronger than normal stimuli such as intense light, pressure or temperature. By

2700-415: The C fibers. These A-delta and C fibers enter the spinal cord via Lissauer's tract and connect with spinal cord nerve fibers in the central gelatinous substance of the spinal cord . These spinal cord fibers then cross the cord via the anterior white commissure and ascend in the spinothalamic tract . Before reaching the brain, the spinothalamic tract splits into the lateral , neospinothalamic tract and

2775-589: The CAT, as of June 2023: A 2021 study in the American Journal of Political Science found that countries that adopt national laws that prohibit torture (defining it in line with the standards codified in the UN Convention against Torture) subsequently experience reductions in police torture. International human rights instruments International human rights instruments can be divided further into global instruments , to which any state in

2850-549: The General Assembly on 18 December 2002 and in force since 22 June 2006, provides for the establishment of "a system of regular visits undertaken by independent international and national bodies to places where people are deprived of their liberty, in order to prevent torture and other cruel, inhuman or degrading treatment or punishment," to be overseen by a Subcommittee on Prevention of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. As of April 2022,

2925-483: The Protocol has 76 signatories and 91 parties. The Committee Against Torture (CAT) is a body of human rights experts that monitors implementation of the convention by State parties. The committee is one of eight UN-linked human rights treaty bodies. All state parties are obliged under the convention to submit regular reports to the CAT on how rights are being implemented. Upon ratifying the convention, states must submit

3000-429: The affective-motivational dimension. Thus, excitement in games or war appears to block both the sensory-discriminative and affective-motivational dimensions of pain, while suggestion and placebos may modulate only the affective-motivational dimension and leave the sensory-discriminative dimension relatively undisturbed. (p. 432) The paper ends with a call to action: "Pain can be treated not only by trying to cut down

3075-407: The ancient Greeks: Hippocrates believed that it was due to an imbalance in vital fluids . In the 11th century, Avicenna theorized that there were a number of feeling senses, including touch, pain, and titillation. In 1644, René Descartes theorized that pain was a disturbance that passed along nerve fibers until the disturbance reached the brain. The work of Descartes and Avicenna prefigured

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3150-471: The brain no longer receives signals. It is a type of neuropathic pain. The prevalence of phantom pain in upper limb amputees is nearly 82%, and in lower limb amputees is 54%. One study found that eight days after amputation, 72% of patients had phantom limb pain, and six months later, 67% reported it. Some amputees experience continuous pain that varies in intensity or quality; others experience several bouts of pain per day, or it may reoccur less often. It

3225-506: The brain. In 1968, Ronald Melzack and Kenneth Casey described chronic pain in terms of its three dimensions: They theorized that pain intensity (the sensory discriminative dimension) and unpleasantness (the affective-motivational dimension) are not simply determined by the magnitude of the painful stimulus, but "higher" cognitive activities can influence perceived intensity and unpleasantness. Cognitive activities may affect both sensory and affective experience, or they may modify primarily

3300-401: The consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in, or incidental to, lawful sanctions. The words "inherent in or incidental to lawful sanctions" remain vague and very broad. It is extremely difficult to determine what sanctions are "inherent in or incidental to lawful sanctions" in

3375-494: The convention and the steps taken by the parties to implement it. It establishes the Committee Against Torture (Article 17), and empowers it to investigate allegations of systematic torture (Article 20). It also establishes an optional dispute-resolution mechanism between parties (Article 21) and allows parties to recognize the competence of the committee to hear complaints from individuals about violations of

3450-428: The convention by a party (Article 22). Part III (Articles 25–33) governs ratification, entry into force, and amendment of the convention. It also includes an optional arbitration mechanism for disputes between parties (Article 30). Article 1.1 of the Convention defines torture as: For the purpose of this Convention, the term "torture" means any act by which severe pain or suffering , whether physical or mental,

3525-413: The drug wearing off in a matter of hours; and small injections of hypertonic saline into the soft tissue between vertebrae produces local pain that radiates into the phantom limb for ten minutes or so and may be followed by hours, weeks, or even longer of partial or total relief from phantom pain. Vigorous vibration or electrical stimulation of the stump, or current from electrodes surgically implanted onto

3600-429: The future. Most pain resolves once the noxious stimulus is removed and the body has healed, but it may persist despite removal of the stimulus and apparent healing of the body. Sometimes pain arises in the absence of any detectable stimulus, damage or disease. Pain is the most common reason for physician consultation in most developed countries. It is a major symptom in many medical conditions, and can interfere with

3675-562: The initial receiving state, but also to states to which the person may be subsequently expelled, returned or extradited. Article 7 obligates the government of the state in which the alleged offense occurred to either prosecute the accused party, or extradite them to a state that will, under the principle of aut dedere aut judicare . Article 16 requires parties to prevent "other acts of cruel, inhuman or degrading treatment or punishment which do not amount to torture as defined in article 1" in any territory under their jurisdiction. Because it

3750-400: The intensity of a stimulus in a procedure called quantitative sensory testing which involves such stimuli as electric current , thermal (heat or cold), mechanical (pressure, touch, vibration), ischemic , or chemical stimuli applied to the subject to evoke a response. The " pain perception threshold " is the point at which the subject begins to feel pain, and the "pain threshold intensity" is

3825-400: The intralaminar nuclei of the thalamus. Pain-related activity in the thalamus spreads to the insular cortex (thought to embody, among other things, the feeling that distinguishes pain from other homeostatic emotions such as itch and nausea) and anterior cingulate cortex (thought to embody, among other things, the affective/motivational element, the unpleasantness of pain), and pain that

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3900-684: The latter is the European Court of Human Rights . Monitoring mechanisms also vary as to the degree of individual access to expose cases of abuse and plea for remedies. Under some conventions or recommendations – e.g. the European Convention on Human Rights – individuals or states are permitted, subject to certain conditions, to take individual cases to a full-fledged tribunal at international level. Sometimes, this can be done in national courts because of universal jurisdiction . The Universal Declaration of Human Rights ,

3975-586: The lawful sanctions clause leaves no scope of application and is widely debated by authors, historians, and scholars alike. Article 2 prohibits torture, and requires parties to take effective measures to prevent it in any territory under their jurisdiction. This prohibition is absolute and non-derogable. "No exceptional circumstances whatsoever" may be invoked to justify torture, including war , threat of war, internal political instability , public emergency , terrorist acts , violent crime , or any form of armed conflict. In other words, torture cannot be justified as

4050-416: The likelihood of reporting pain. Patients may feel that certain treatments go against their religious beliefs. They may not report pain because they feel it is a sign that death is near. Many people fear the stigma of addiction, and avoid pain treatment so as not to be prescribed potentially addicting drugs. Many Asians do not want to lose respect in society by admitting they are in pain and need help, believing

4125-575: The mid-1890s, specificity was backed primarily by physiologists and physicians, and psychologists mostly backed the intensive theory . However, after a series of clinical observations by Henry Head and experiments by Max von Frey , the psychologists migrated to specificity almost en masse. By the century's end, most physiology and psychology textbooks presented pain specificity as fact. Some sensory fibers do not differentiate between noxious and non-noxious stimuli, while others (i.e., nociceptors ) respond only to noxious, high-intensity stimuli. At

4200-480: The noxious stimulus is removed or the underlying damage or pathology has healed. But some painful conditions, such as rheumatoid arthritis , peripheral neuropathy , cancer , and idiopathic pain, may persist for years. Pain that lasts a long time is called " chronic " or "persistent", and pain that resolves quickly is called " acute ". Traditionally, the distinction between acute and chronic pain has relied upon an arbitrary interval of time between onset and resolution;

4275-400: The pain should be borne in silence, while other cultures feel they should report pain immediately to receive immediate relief. Gender can also be a perceived factor in reporting pain. Gender differences can be the result of social and cultural expectations, with, in some cultures, women expected to be more emotional and show pain, and men to be more stoic. As a result, female pain may be at

4350-487: The pain stimulus. Insensitivity to pain may also result from abnormalities in the nervous system . This is usually the result of acquired damage to the nerves, such as spinal cord injury , diabetes mellitus ( diabetic neuropathy ), or leprosy in countries where that disease is prevalent. These individuals are at risk of tissue damage and infection due to undiscovered injuries. People with diabetes-related nerve damage, for instance, sustain poorly-healing foot ulcers as

4425-400: The pain will help the examining physician to accurately diagnose the problem. For example, chest pain described as extreme heaviness may indicate myocardial infarction , while chest pain described as tearing may indicate aortic dissection . Functional magnetic resonance imaging brain scanning has been used to measure pain, and correlates well with self-reported pain. Nociceptive pain

4500-497: The patient's regular pain management . It is common in cancer patients who often have background pain that is generally well-controlled by medications, but who also sometimes experience bouts of severe pain that from time to time "breaks through" the medication. The characteristics of breakthrough cancer pain vary from person to person and according to the cause. Management of breakthrough pain can entail intensive use of opioids , including fentanyl . The ability to experience pain

4575-512: The peripheral end of the nociceptor, noxious stimuli generate currents that, above a given threshold, send signals along the nerve fiber to the spinal cord. The "specificity" (whether it responds to thermal, chemical, or mechanical features of its environment) of a nociceptor is determined by which ion channels it expresses at its peripheral end. So far, dozens of types of nociceptor ion channels have been identified, and their exact functions are still being determined. The pain signal travels from

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4650-491: The periphery to the spinal cord along A-delta and C fibers. Because the A-delta fiber is thicker than the C fiber, and is thinly sheathed in an electrically insulating material ( myelin ), it carries its signal faster (5–30  m/s ) than the unmyelinated C fiber (0.5–2 m/s). Pain evoked by the A-delta fibers is described as sharp and is felt first. This is followed by a duller pain—often described as burning—carried by

4725-587: The prohibition against torture (Article 10). Parties also must keep interrogation rules, instructions, methods, and practices under systematic review regarding individuals who are under custody or physical control in any territory under their jurisdiction, in order to prevent all acts of torture (Article 11). Parties are also obliged to prevent all acts of cruel, inhuman, or degrading treatment or punishment in any territory under their jurisdiction, and to investigate any allegation of such treatment. (Article 16). Part II (Articles 17–24) governs reporting and monitoring of

4800-474: The question of why pain should have the quality of being painful. He describes the alternative as a mental raising of a "red flag". To argue why that red flag might be insufficient, Dawkins argues that drives must compete with one another within living beings. The most "fit" creature would be the one whose pains are well balanced. Those pains which mean certain death when ignored will become the most powerfully felt. The relative intensities of pain, then, may resemble

4875-537: The relative importance of that risk to our ancestors. This resemblance will not be perfect, however, because natural selection can be a poor designer . This may have maladaptive results such as supernormal stimuli . Pain, however, does not only wave a "red flag" within living beings but may also act as a warning sign and a call for help to other living beings. Especially in humans who readily helped each other in case of sickness or injury throughout their evolutionary history, pain might be shaped by natural selection to be

4950-473: The rules with a semblance of legal binding force. This allows state parties to pass domestic laws that permit acts of torture that they believe are within the lawful sanctions clause. However, the most widely adopted interpretation of the lawful sanctions clause is that it refers to sanctions authorized by international law . Pursuant to this interpretation, only sanctions that are authorized by international law will fall within this exclusion. The interpretation of

5025-654: The sensory input by anesthetic block, surgical intervention and the like, but also by influencing the motivational-affective and cognitive factors as well." (p. 435) Pain is part of the body's defense system, producing a reflexive retraction from the painful stimulus, and tendencies to protect the affected body part while it heals, and avoid that harmful situation in the future. It is an important part of animal life, vital to healthy survival. People with congenital insensitivity to pain have reduced life expectancy . In The Greatest Show on Earth: The Evidence for Evolution , biologist Richard Dawkins addresses

5100-535: The spinal cord, all produce relief in some patients. Mirror box therapy produces the illusion of movement and touch in a phantom limb which in turn may cause a reduction in pain. Paraplegia , the loss of sensation and voluntary motor control after serious spinal cord damage, may be accompanied by girdle pain at the level of the spinal cord damage, visceral pain evoked by a filling bladder or bowel, or, in five to ten percent of paraplegics, phantom body pain in areas of complete sensory loss. This phantom body pain

5175-408: The stimulus intensity at which the stimulus begins to hurt. The " pain tolerance threshold" is reached when the subject acts to stop the pain. A person's self-report is the most reliable measure of pain. Some health care professionals may underestimate pain severity. A definition of pain widely employed in nursing, emphasizing its subjective nature and the importance of believing patient reports,

5250-460: The two most commonly used markers being 3 months and 6 months since the onset of pain, though some theorists and researchers have placed the transition from acute to chronic pain at 12 months. Others apply "acute" to pain that lasts less than 30 days, "chronic" to pain of more than six months' duration, and "subacute" to pain that lasts from one to six months. A popular alternative definition of "chronic pain", involving no arbitrarily fixed duration,

5325-463: The use of evidence produced by torture in their courts (Article 15), and are barred from deporting , extraditing, or refouling people where there are substantial grounds for believing they will be tortured (Article 3). Parties are required to train and educate their public servants and private citizens involved in the custody , interrogation , or treatment of any individual subjected to any form of arrest , detention, or imprisonment , regarding

5400-410: The use of medication . Depression may also keep older adult from reporting they are in pain. Decline in self-care may also indicate the older adult is experiencing pain. They may be reluctant to report pain because they do not want to be perceived as weak, or may feel it is impolite or shameful to complain, or they may feel the pain is a form of deserved punishment. Cultural barriers may also affect

5475-554: The word peyn comes from the Old French peine , in turn from Latin poena meaning "punishment, penalty" (also meaning "torment, hardship, suffering" in Late Latin) and that from Greek ποινή ( poine ), generally meaning "price paid, penalty, punishment". The International Association for the Study of Pain recommends using specific features to describe a patient's pain: Pain is usually transitory, lasting only until

5550-549: The world can be a party, and regional instruments , which are restricted to states in a particular region of the world. Most conventions and recommendations (but few declarations) establish mechanisms for monitoring and establish bodies to oversee their implementation. In some cases these bodies that may have relatively little political authority or legal means, and may be ignored by member states; in other cases these mechanisms have bodies with great political authority and their decisions are almost always implemented. A good example of

5625-553: Was introduced by Margo McCaffery in 1968: "Pain is whatever the experiencing person says it is, existing whenever he says it does". To assess intensity, the patient may be asked to locate their pain on a scale of 0 to 10, with 0 being no pain at all, and 10 the worst pain they have ever felt. Quality can be established by having the patient complete the McGill Pain Questionnaire indicating which words best describe their pain. The visual analogue scale

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