The diagnosis and management of chronic pain

Chronic or persistent pain lasting longer than 3 months is not an uncommon problem in western Europe. It is associated with psychosocial effects that may have a serious effect on a patient’s general health. Chronic pain may be nociceptive, neuropathic or mixed in nature, which may be borne out by the history and examination. Clinical examination should include an assessment of pain severity to ascertain the effects of subsequent treatment. Management of chronic pain tends to be multimodal and aims at controlling the pain to optimize patient function.