Recent advances in pain management.

Over the last 20 years there has been an upsurge of interest in the basic mechanisms of pain. The findings that have arisen as a result of this interest have flowed through to the clinical area and have seen applications in a variety of settings. Identification of receptors and processes that are involved in the transmission of pain has led to the use of new agents in pain management. New techniques have provided new and more effective approaches in managing pain. These include the use of pre-emptive analgesia, postoperative pain management with patient controlled analgesia and use of techniques such as intrathecal drug administration and epidural spinal cord stimulation. This review presents some of the findings from basic research which have led to these developments, in particular those that relate to the changes that occur following inflammation and nerve injury, and the implications that these findings have had on pain management.