The management of the chronic pain patient: clinical considerations

Virtually everyone has experienced pain and it is reasonable to assume that individuals have sought out healers for pain since prehistoric times. There is an extensive literature about pain covering its definition, anatomy, physiology, psychology, and means of relieving it. However, it appears safe to say that the most significant advances have occurred during the last 25 to 30 years. Here, we will be concerned with the treatment of patients whose pain has been present six months or longer and which is not the result of a life-threatening or function-threatening disease process. Such pain is generally referred to as chronic benign, pain. At the present time, there are an increasing number of programs designed to deal with this problem, and health care providers are becoming more sophisticated in their understanding of chronic pain syndromes. In the material, which follows, the complexities of the problem are detailed from a multidisciplinary but integrated point of view.J Orthop Sports Phys Ther 194;5(6):305-307.