Strategies for multidisciplinary pain management

Several recent articles in the Compendium have emphasized the importance of differentiating between acute and chronic pain for purposes of appropriate clinical management. The patient with long-standing pain complaints that has not responded favorably to appropriate medical, surgical, or pharmacologic treatment poses a formidable management problem. After clarifying the clinical and experiential differences between acute and chronic pain, this article will discuss clinical signs that may identify the chronic pain patient. Strategies for enlisting cooperation with referral procedures, common resistances, and tactics for dealing with nonadherence will be presented to provide the dentist with interpersonal directions for optimizing patient involvement in multidisciplinary pain treatment programs.