#DearCDC: Is chronic/intractable pain a disease?

I had a recent conversation in a comment section about the definition of disease. The dude said that addiction and depression aren’t diseases. And I’m like, would it make you feel better if I called them medical conditions? No? So, when the brain is sick, that’s not a disease or medical condition?

How about when the nervous system is sick, like with chronic pain? Is chronic/intractable pain a disease? Let’s look at some definitions of disease:

(1) a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.

(2) an illness that affects a person, animal, or plant; a condition that prevents the body or mind from working normally.

(3) a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment.

I’d say that intractable pain fits these definitions. Let’s read further:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1299105/

(2004) What is a disease?

At first sight, the answer to “What is a disease?” is straightforward. Most of us feel we have an intuitive grasp of the idea, reaching mentally to images or memories of colds, cancer or tuberculosis. But a look through any medical dictionary soon shows that articulating a satisfactory definition of disease is surprisingly difficult. And it is not much help defining disease as the opposite of health, given that definitions of health are equally tricky. The World Health Organization’s claim that health is “a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity” (WHO, 1946) has been praised for embracing a holistic viewpoint, and equally strongly condemned for being wildly utopian: the historian Robert Hughes remarked that it was “more realistic for a bovine than a human state of existence” …

What counts as a disease also changes over historical time, partly as a result of increasing expectations of health, partly due to changes in diagnostic ability, but mostly for a mixture of social and economic reasons. One example is osteoporosis, which after being officially recognized as a disease by the WHO in 1994 switched from being an unavoidable part of normal ageing to a pathology (WHO, 1994). This has consequences for sufferers’ sense of whether they are ‘normally old’ or ‘ill’, but more concretely for their ability to have treatment reimbursed by health service providers.

Another well-known example is homosexuality, which has travelled in the opposite direction to osteoporosis, through medical territory, and out the other side. After being redefined during the nineteenth century as a state rather than an act, in the first half of the twentieth century homosexuality was viewed as an endocrine disturbance requiring hormone treatment. Later its pathological identity changed as it was re-categorized as an organic mental disorder treatable by electroshock and sometimes neurosurgery; and finally in 1974 it was officially de-pathologized, when the American Psychiatric Association removed it from the listed disease states in the Diagnostic and Statistical Manual IV…

Intractable pain should be classified as a disease. It fits the definitions. It could also fit the definition for cancer:

“the disease caused by an uncontrolled division of abnormal cells in a part of the body”

Chronic pain is caused by abnormal and uncontrolled activity in the body’s nervous system. Do pain patients have to die for this medical condition to be taken seriously? Cancer is no longer always terminal, and intractable pain is not immediately terminal. But this is about quality of life and how the disease of constant pain can remove all quality of life. What’s quantity without quality? It’s misery.

I posted this comment on CDC’s Facebook page entitled:  “Today is One Health Day! Diseases are shared between people, animals, and our environment.”

#DearCDC: Is chronic/intractable pain a disease? How about addiction and depression?

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