pain relief

Although pain is one of the most common human experiences, the scientific discipline of pain research and the medical subspecialty of pain management are relatively new fields. Prior to the 1800s, pain was largely viewed as an existential experience and accepted as a consequence of aging (Meldrum, 2003), but the twentieth century saw the medicalization of pain management with a growth in the knowledge of pain pathophysiology and in the variety of pain treatment strategies. This paper will focus on chronic pain, as this is an emerging field with high public health importance, and will provide (1) a review of the etiology of chronic pain, (2) an overview of the history of chronic pain management – including reasons behind the dramatic rise in opioids for the treatment of most chronic pain disorders, (3) an overview of non-opioid analgesic treatment strategies, and (4) guidance for future pain research needs. To ensure consistency throughout this paper, it is important to first define chronic pain. Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (International Association for the Study of Pain, 1986). In this definition, pain is understood not just as a function of neuronal activity, but highlights the importance of higher-level cognitive processes that help interpret and define the pain experience for individuals. Pain is understood as an inherently subjective experience that does not require identifiable tissue damage to be clinically significant. Chronic pain is defined as pain that has lasted beyond the normal healing time for a given injury, operationalized as pain lasting >3 months (International Association for the Study of Pain, 1986). For treatment purposes, chronic pain is further divided as associated with or not associated with a terminal illness (usually cancer pain releif