Aronoff G M
J Med. 1982;13(3):191-202.
Chronic pain remains an enigma which mystifies the most experienced clinicians. The traditional approaches to malignant pain employ narcotic analgesics, radiotherapy, surgical intervention, and chemotherapy. Within the context of a "therapeutic community" oriented pain unit, we attack this major public health problem differently. The use of non-narcotic analgesics, mood altering medications, various forms of psychotherapy (individual, group, family, gestalt, psychomotor) and peer pressure when used in conjunction with various physical modalities of treatment (including biofeedback, transcutaneous electrical nerve stimulator, physical therapy, whirlpool, massage, ice, heat, etc.) appear most efficacious. Frequently, the powerful tools of psychological medicine are taken for granted; yet, depression in the United States is widespread and so significantly complicates medical illness that any treatment program designed for pain patients must be holistic in its orientation if it is to be effective.
慢性疼痛仍然是一个谜，让最有经验的临床医生也感到困惑。治疗恶性疼痛的传统方法包括使用麻醉性镇痛药、放射疗法、手术干预和化疗。在一个以“治疗社区”为导向的疼痛治疗单元中，我们以不同的方式处理这个重大的公共卫生问题。使用非麻醉性镇痛药、改变情绪的药物、各种形式的心理治疗（个体、团体、家庭、格式塔、心理运动）以及同伴压力，同时结合各种物理治疗方式（包括生物反馈、经皮电神经刺激器、物理治疗、漩涡浴、按摩、冰敷、热敷等），似乎最为有效。通常，心理医学的强大工具被视为理所当然；然而，在美国，抑郁症很普遍，并且严重地使疾病复杂化。因此，如果要有效，任何为疼痛患者设计的治疗方案都必须是全面的。
