Introduction to chronic pain management

Approximately one in five Australian children and adults experience chronic pain, and this increases to one in three adults over 65 years of age. In up to 5%, chronic pain has a significant impact on function and quality of life.

Chronic pain is a complex medical condition, best understood using a sociopsychobiomedical framework. Chronic pain affects, and is affected by, multiple dimensions of a patient’s life, including their:

• social environment
• thoughts and emotions
• physical health and deconditioning
• sleep
• nutrition.

Central sensitisation is often a more important contributor to chronic pain than structural change in body tissues. This makes it harder for patients and the general population to understand chronic pain; this misunderstanding leads to stigma and additional social suffering.

Chronic pain management aims to help patients and their carers understand chronic pain, reduce central sensitisation and pain intensity, and improve social, emotional and physical functioning.

Key components of chronic pain management include:

• comprehensive assessment
• use of a multidimensional approach
• supported self-management
• patient education
• healthcare providers understanding their role in management
• regularly monitoring patients to check their pain intensity, function and quality of life, and the adequacy of therapy
• providing long-term support as required.