563: Why Can't We Describe �Shibire�? The Communication Gap in Everyday Japanese Symptom Language

Topic: Education, Societal Impact, and Others
Subtopic: Definition and classification

Background and Aims: Describing subjective sensations creates a universal "communication gap" [1]. Clinically, the Japanese term “Shibire” represents a significant distress distinct from pain or itch, necessitating specific intervention. However, the meaning of this term is remarkably unstable, varying among individuals by indiscriminately conflating Positive Sensory Symptoms (PSS; e.g., tingling), Negative Sensory Symptoms (NSS; e.g., numbness), and Perceived Motor Weakness (PMW; e.g., subjective motor complaints) [2]. We aimed to quantify this semantic variability in both general and clinical populations to demonstrate how a single linguistic label can obscure the precise profile of this distinct distress.

Methods: To investigate the discrepancy in how Shibire is conceptualized, we compared definitions across two distinct cohorts. The General Population Cohort consisted of respondents from a nationwide internet survey. The Clinical Cohort comprised adult patients complaining of Shibire recruited from a multicenter study. Participants in both cohorts were asked to deconstruct their definition of Shibire by selecting its components: PSS, NSS, and PMW. We analyzed the variability in these definitions to reveal the magnitude of the discrepancy in understanding.

Results: In the General Population Cohort (valid responses: n=581), definitions were highly fragmented. While the largest subgroup (37.9%) defined Shibire as a triad of all three components (PSS+NSS+PMW), the most frequently endorsed component overall was PSS (85.7%). Regarding pain, 51.8% of the general population considered Shibire to be related to pain. In the Clinical Cohort (n=349), the definition remained similarly heterogeneous, with the triad being the most common (43.3%). However, the association with pain was notably higher (70.8%). Crucially, patients included PSS in their definition significantly more frequently (95.1%) than the general population, despite maintaining the broad, multi-component definition.

Conclusions: Our study confirms that the word Shibire masks the true nature of symptoms. Even when patients experience intense pain-like tingling (PSS), they continue to use this standard but ambiguous term that implies numbness or weakness, creating a risk of misinterpreting the symptom profile. This finding highlights a broader, universal issue in pain assessment. It compels us to consider the potential discrepancy between standard English terminology (e.g., paresthesia or numbness) and the native descriptors used by patients in other cultures. Investigating whether similar "umbrella terms" exist in other languages is essential to unmask precise symptom profiles and enable mechanism-based management [3].

References: [1] Nagai S, et al. The relationship between numbness and quality of life. J Clin Med. 2023;12(4):1324. [2] Yamamoto A, et al. Development of Shibire Questionnaire in Neurosurgical Disorders. Jpn J Neurosurg (Tokyo). 2025;34(7):397-405. [3] Baron R, et al. Peripheral neuropathic pain: a mechanism-related organizing principle based on sensory profiles. Pain. 2017;158(2):261–272.

Presenting Author: Akihiro Yamamoto
Submitting Author: Akihiro Yamamoto

Senior Author: Koichi Hosomi

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Koichi Hosomi: MD, PhD - Department of Neurosurgery, The University of Osaka Graduate School of Medicine
• Keiko Yamada: MD, PhD - Pain Medicine, Juntendo University Graduate School of Medicine
• Nobuhiko Mori: PT, MHSc - Department of Neurosurgery, The University of Osaka Graduate School of Medicine
• Naoki Mizunuma: JD, PhD - Department of Legal Medicine, Toho University School of Medicine
• Yoichi Matsuda: MD, PhD - Department of Anesthesiology and Intensive Care Medicine, The University of Osaka Graduate School of Medicine
• Ayako Takahashi: MD, PhD - Department of Anesthesiology and Intensive Care Medicine
• Momoyu Yamanaka: MD - Department of Anesthesiology and Intensive Care Medicine, The University of Osaka Graduate School of Medicine
• Hiroshi Horiike: MD - Department of Anesthesiology and Intensive Care Medicine, The University of Osaka Graduate School of Medicine
• Takahito Fujimori: MD, PhD - Department of Orthopaedic Surgery, The University of Osaka Graduate School of Medicine
• Masayuki Furuya: MD, PhD - Department of Orthopaedic Surgery, The University of Osaka Graduate School of Medicine
• Yuya Kanie: MD - Department of Orthopaedic Surgery, The University of Osaka Graduate School of Medicine
• Koshi Ninomiya: MD, PhD - Department of Neurosurgery, The University of Osaka Graduate School of Medicine
• Asaya Nishi: MD - Department of Neurosurgery, Hanwa Memorial Hospital
• Tatsusada Okuno: MD, PhD - Department of Neurology, The University of Osaka Graduate School of Medicine
• Makoto Kinoshita: MD, PhD - Clinical laboratory department, NHO Osaka Toneyama Medical Center
• Tomohiko Nishigami: PhD - Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima
• Masahiro Manfuku: PhD - Department of Rehabilitation, Breast Care Sensyu Clinic
• Hui Ming Khoo: MD, PhD - Department of Neurosurgery, The University of Osaka Graduate School of Medicine
• Naoki Tani: MD, PhD - Department of Neurosurgery, The University of Osaka Graduate School of Medicine
• Satoru Oshino: MD, PhD - Department of Neurosurgery, The University of Osaka Graduate School of Medicine
• Manabu Sasaki: MD, PhD - Department of Neurosurgery, The University of Osaka Graduate School of Medicine
• Masahiko Shibata: MD, PhD - Faculty of Health Sciences, Naragakuen University
• Haruhiko Kishima: MD, PhD - Department of Neurosurgery, The University of Osaka Graduate School of Medicine