[Pain in Italy. Background examination. Operative proposals]

The aim of this document is to protect public health through the diffusion on the national territory of appropriate pain treatment guidelines and the definition of a practical, diagnostic and therapeutic tool, which contributes to the diffusion of Law no. 38/2010, particularly through information and health professionals training. The lack of systematic pain evaluation and of an appropriate diagnostic-therapeutic approach are the main issues that make patients treatment remains very poor and inadequate. The 41% of patients with chronic pain states they have not received adequate pain control. The pain incidence in the Italian population is 21.7%, which corresponds to approximately 13 million inhabitants. Consequently, becomes significant identifying the tools and methods to help health professionals to recognize the pain nature, providing a global intervention, which includes the evaluation of patient and of the pathology's clinical characteristics, in order to guarantee an adequate therapeutic choice and a minimization of risks associated with therapy. International guidelines for pain management recommend pain evaluation according to its characteristics, in order to recognize the pain nature (nociceptive pain - inflammatory pain and structural mechanical pain -, neuropathic pain) and an adequate therapy, taking into account pain intensity (analgesics or their associations for management of non-inflammatory pain; for management of inflammatory pain, NSAIDs which may be associated with a central analgesic; drugs with action on ion channels and on neurotransmitters reuptake for management of neuropathic pain). The inadequate management of "pain's suffering patient" underlined the need for health professionals to dispose of a practical and effective tool, a "methods-guide". This tool wishes to become a valuable support for pain examination, from first diagnostic approach to appropriate prescription's dispensing. Authors hope to guide health professionals in the right direction to achieve the cultural change awaited from the application of Law no. 38/2010.