Although the multidimensional nature of pain experience is acknowledged by many researchers, the relationships among dimensions are not always clarified. An important issue concerns the relationship between the nociceptive system, which is part of the peripheral nervous system, and the interoceptive experience of pain, which is encroached by cognitive and emotional processes. Some researchers in the neurosciences, and in philosophy, hold what we will refer to as the “dispensability view”: that the nociceptive system is contingent on the experience of pain. Accordingly, nociceptive activation is sufficient, but not necessary to pain experience. At first glance, this view seems suitable for explaining pain cases that are difficult to diagnose, such as certain types of chronic pain and phantom limb pain. However, the view is that it fails to address two desiderata of pain theories: first, a conceptual issue, consists of the difficulty experienced by chronic pain patients in reporting their own pain. Second, an empirical issue, relates to recent research relating chronic pain to problems in pain signal processing due to a hypersensitivity of the nociceptive system that overburden the interoception. These two desiderata are closely connected: the hypersensitivity of the nociceptive system overloads interoception, thereby exceeding the descriptive capabilities of patients. Thus, we will argue that for a theory of pain to meet these desiderata, it must commit to the indispensability of the nociceptive system.
