Pain management - the challenge.

Chronic pain is a significant public health problem in the United States. While the understanding that pain is an important biological signal has always been appreciated by health care professionals, management of pain has now come under significant scrutiny following its recognition as the fifth vital sign. Since the measurement of pain is not objective, the answers to questions regarding how to best manage the problem are not always self-evident. Multiple modalities, including interventional procedures and noninvasive techniques, are available for the treatment of pain. Acute pain is usually self-limiting when a reversible element can be identified. If acute pain is undertreated, it may become chronic in nature with the attendant problems of prolonged pain. Chronic pain creates psychological and social problems that are difficult and frustrating for both patient and physician. A multimodal therapeutic program in which the patient is an active participant can satisfactorily manage most pain problems. The use of opioids is considered legitimate medical therapy for chronic nonmalignant pain. If the need for opioid therapy is felt to be indicated, the physician should adhere to recommended guidelines as published by state licensing boards and professional organizations. Successful pain management is a rewarding experience for health care professionals.