[Modern pain therapy in general practice. "Pain is what the patient perceives as pain"]

Virtually one person in two is afflicted by pain. In many cases its management, in particular the chronic form, is anything but appropriate to the patient's actual needs. Adequate pain treatment begins with the acceptance of the patient's perception of pain. Pain must be differentiated not only by its cause, nature and intensity, but also by psychosocial factors (unemployment, poverty). Within the framework of a comprehensive communicative interchange between physician and patient, self-medication and explanation models offered by the patient, must be considered. An important task for the general practitioner is to appreciate the "plastic phase" of pain, in which pain memory begins to develop, so as to initiate effective analgesia early on. For this purpose, it is essential that the physician be familiar with the interfaces with specialists, as also with the WHO stepped schema, in particular the indication for powerful stage III analgesics, and with the possible need for accompanying medication.