Managing the pain of advanced chronic disease.

Persons with life-limiting illness such as cancer, congestive heart failure, chronic obstructive pulmonary disease, and other organ system failure may needlessly endure severe pain for months or even years as the disease progresses. Adequately assessing and treating pain and other factors associated with advancing disability often dramatically alters the patient's experience of the disease process. Regulations concerning the use of controlled substances for the treatment of chronic pain are reviewed, and a simple yet thorough pain assessment and treatment strategy is presented. Physicians practicing these palliative skills will be gratified when caring for patients with chronic, life-limiting illness, as the potential exists for improving patient well-being, even in the face of advancing disease and ensuing disability.