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Feature Article

Managing chronic nonmalignant pain

David A Cherry
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Abstract

Chronic nonmalignant pain is unlikely to resolve spontaneously and, in most cases, management of patients with this condition will be ongoing. The treatment of choice should be tailored to the type of pain the patient is experiencing.

Key Points

  • In 2007 there were 3.2 million people in Australia experiencing chronic pain, defined as pain lasting more than three months.
  • The causes of pain behaviour are nociceptive pain, neuropathic pain or pain disorders.
  • Chronic pain is very unlikely to resolve spontaneously and in most cases treatment can be assumed to be ongoing.
  • An opioid trial should be considered in patients with nociceptive pain; anticonvulsants should be the treatment of choice for patients with neuropathic pain; and psychological management should be used for the treatment of patients with pain disorders in the absence of nociceptive and neuropathic pain.
  • The common chronic pain management pitfalls such as resting when in pain and treating the site of referred pain should be avoided.

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