title: [Definition of chronic pain and the organization of Pain Centers].
abstract: Chronic pain is defined by its length (more than six months) and its resistance to conventional therapies. It has been studied for about a decade in France. The outpatient departments devoted to chronic pain are pluri-disciplinary. They are likely to pave the way for a transversal specialization encompassing many conventional medical specialties. Moreover, chronic pain is nowadays considered not only the consequence of a lesion but also an independent entity, to be cared for itself. In the first conception, the struggle against pain is merely a stage in an overall treatment involving neuro-surgeons, anasthesiologists and medical specialists. In the second conception, the patient's behavior is rigorously monitored by all the caring team, who analyze his reactions to stimuli that generate pain. This (second) emerging pain conception creates tensions among physicians. The problem is how to adopt it without breaking down the professional cohesion. Another issue is the variation of the therapeutic procedure. The latter does not involve the same actors in every case, and this is an additional challenge.
authors.affiliation: Centre National de la Recherche Scientifique, Cermes, Paris.
authors.forename: I
authors.initials: I
authors.lastname: Baszanger
mesh_terms: D002908:Chronic Disease; D005602:France; D006763:Hospitals, Chronic Disease / Q000458:organization & administration*; D006782:Hospitals, Special / Q000458:organization & administration*; D006801:Humans; D010148:Intractable Pain / Q000503:physiopathology / Q000628:therapy*; D000078329:Workforce
vernacular_title: Définition de la douleur chronique et organisation des centres de la douleur.