Comprehensive chronic pain management: improving physical and psychological function (CME multimedia activity).


Journal Article

As shown in this CME online activity (, chronic, non-cancer pain can arise from a variety of etiologies and can be broadly classified based on its underlying mechanism as nociceptive, inflammatory, neuropathic, or central, with some patients having pain arising from a combination of mechanisms. Chronic pain assessment and treatment involves evaluating not only its biological aspects, but also psychological and sociocultural factors. Beyond neural mechanisms, a patient's perception of chronic pain can be influenced by comorbid mood disorders, such as depression and anxiety; cognitive and affective traits, such as catastrophizing and fear-avoidance; environmental stressors, family relationships, social support, and cultural beliefs. Based on this biopsychosocial model, a multidisciplinary approach to management incorporates pharmacotherapy (opioid, nonopioid, and centrally-acting analgesics, and pain adjuvant medications) with nonpharmacologic physical rehabilitation and psychological and behavioral therapies to address the multifactorial causes of chronic pain, which in turn leads to improvement of physical and psychological function.

Full Text

Cited Authors

  • McCarberg, BH; Stanos, S; Williams, DA

Published Date

  • June 2012

Published In

Volume / Issue

  • 125 / 6

Start / End Page

  • S1 -

PubMed ID

  • 22624694

Pubmed Central ID

  • 22624694

Electronic International Standard Serial Number (EISSN)

  • 1555-7162

International Standard Serial Number (ISSN)

  • 0002-9343

Digital Object Identifier (DOI)

  • 10.1016/j.amjmed.2011.10.004


  • eng