Treating Chronic Pain: New Knowledge, More Choices

Kaiser Permanente, The Permanente Medical Group, The Permanente Federation


Christine E Whitten, MD; Marilee Donovan, RN, PhD; Kristene Cristobal, MS

Fall 2005 - Volume 9 Number 4

https://doi.org/10.7812/TPP/05-067

Introduction

In routine medical practice, treatment for primary pain fails to achieve adequate relief in at least 40% of patients even though effective treatments are currently available.1 Many clinicians were trained years ago, when little was known about pain. The rapid expansion of knowledge about pain mechanisms challenges health care practitioners to keep their knowledge base current. Myths, misconceptions, and the resulting fears often bridge gaps in this knowledge. Lack of knowledge limits treatment choices and may hinder desired patient outcomes by allowing pain hypersensitivity and progressive dysfunction to develop (Table 1).

This article--the third in a series about management of chronic pain--offers practical treatment advice based on the newest science. Readers who seek more detail are referred to several recent reviews that provide more complete descriptions of cellular mechanisms.2,3

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