Introduction

The management of pain can be approached in a number of ways. Many people suffering from pain, particularly acute pain, successfully self-manage their pain. If this fails, a trip to the emergency department, primary care physician, or pain specialist may help. If none of this helps, surgery may be considered. Increasingly, an integrative approach to pain management is being used. Integrative medicine provides patient-centered care, addressing physical, emotional, mental, social, spiritual, and environmental influences that affect a person’s health. Integrative medicine uses the most appropriate interventions from an array of scientific disciplines to heal illness and help people regain and maintain optimum health.

 

Inadequate treatment of pain is widespread throughout surgical wards, intensive care units, accident and emergency departments, in general practice, in the management of all forms of chronic pain including cancer pain, and in end of life care. This neglect is extended to all ages, from neonates to the frail elderly.

 

The International Association for the Study of Pain advocates that the relief of pain should be recognized as a human right that chronic pain should be considered a disease in its own right, and that pain medicine should have the full status of a specialty.

 

Current treatment of chronic pain is largely based on the severity of pain. The World Health Organization (WHO) three-step pain ladder, for example, advocates the initial use of non-opioids, followed by weak opioids and strong opioids based on the severity of pain increases. However, since most chronic pain conditions are multifactorial in nature (e.g. nociceptive and neuropathic components present) effective pain management needs to take into account the underlying mechanisms in order to choose the most targeted treatment.