[Long-term pain therapy].

In contrast to acute pain, chronic pain develops as a lasting disturbance of physiological control circuits because of (a) pathological sympathetic and motor reflexes, (b) biochemically induced plastic changes of the CNS with central learning phenomena and (c) psychologically as reaction to the somatic disturbance or as a substitute for intrapsychic conflicts. Therefore the long-term treatment of chronic pain has to be complex, taking into account not only the reduction of pain, but also physical functional restoration, psychological stabilisation and social rehabilitation.