[Chronic pain conditions--causes, manifestations and neurosurgical treatment possibilities]

The relief of chronic pain, which had lost its warning function and had become a disease entity, is one of the main scopes of the so-called "functional neurosurgery". If it is impossible to eliminate the origin of chronic pain condition, or if conservative treatment is not effective, this is an indication for a surgical intervention. "Destructive methods" in pain surgery aim at interrupting the pathway of pain in one of its three steps (neurons). The decision which method should be used depends on character and localisation of pain and requires well-founded experience by the surgeon. "Non-destructive" operations include stimulation methods of several CNS areas as well as implantation of drug reservoirs which conceded a continuous release of morphine or morphine derivatives to the opiate receptors of the spinal cord. The paper evaluates the most common surgical procedures in pain relief concerning technique, indication and efficacy and gives a survey on the pathophysiological background of chronic pain.