Congenital Insensitivity to Pain: A Misnomer

J Pain. 2019 Sep;20(9):1011-1014. doi: 10.1016/j.jpain.2019.01.331. Epub 2019 Feb 2.


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.

Keywords: Congenital insensitivity to pain; experience; nociception; nociceptor; pain.

Publication types

  • Review

MeSH terms

  • Humans
  • Nociception / physiology*
  • Pain Insensitivity, Congenital / diagnosis*
  • Pain Insensitivity, Congenital / physiopathology
  • Pain Perception / physiology*