Chronic pain - The state of the art

The author discusses the modern approach to pain treatment quoting the opinion of Bonica concerning the need for a multidisciplinary approach to pain management. The paper presents the outline of modern methods, such as controlled-release opioids, implantable drug delivery systems, special pharmacological regimes for neuropathic pain, outpatient regimes as a way of economising the procedures, the use of dorsal column stimulation, the utilisation of intrathecal morphine pumps, radiofrequency lesioning and pulsed radiofrequency lesioning and finally as one of the newest methods - spinal endoscopy in back pain patients. New drugs are also listed. The author does not fail to stress the role psychological strategies and finally alternative medicine techniques. Finally, the paper concludes with a repetition of the WHO three-stepped ladder of pain treatment.

Duke Scholars

Author Winston Clive Victor Parris Anesthesiology, Pain Management