The Pain Crisis: What It Is and What Can Be Done

Table 1

Recent advances in pain research and management.

(i) Identification of peripheral and central nociceptive processes involving nonneural as well as neural mechanisms
(ii) Discovery of several endogenous neurochemicals and intrinsic pathways in the brain and their influences on nociceptive
transmission and behaviour
(iii) Development of concepts and insights of the neuroplasticity of pain processing that can lead to chronic pain
(iv) Rapid advances in the fields of brain imaging, biomarkers, genetics, and molecular biology as well as their applicability to the pain field
(v) Recognition of the multidimensionality of pain and importance of biopsychosocial factors in pain expression and behaviour
(vi) Improvements in surgical, pharmacological, and behavioural management of pain:
(a) more effective and varied drug-delivery systems
(b) broader range of analgesics and other drugs for management of pain and related conditions
(c) spinal cord and brain stimulation, transcutaneous electrical nerve stimulation
(d) physical/rehabilitative medicine
(e) new or improved surgical approaches
(f) cognitive behavioural therapy