title: The place of the pain clinic.
abstract: Chronic pain is a debilitating and degrading condition. Its aetiology is largely multifactorial, and only proper appreciation of the various factors which can combine to produce the patient's misery will allow appropriate therapies. If the mechanisms of chronic pain were better taught and the therapies available were better used by medical practitioners, then the standard of alleviation of pain would increase greatly. There is an urgent need for greatly improved facilities for treating chronic pain by multidisciplinary groups in specialized clinics, a fact which has been realized for over 30 years. However, in spite of this there is a great delay in the setting up of such units. There is also an urgent need for proper training of doctors in pain relief, and a need for a much larger amount of money to be spent on research into the causes and treatment of human pain. It is disturbing to me that so much money goes on research into possible cures of malignant disease in the future, which is all very well, but which does not help the sufferer from severe pain at the present time; whereas these poor unfortunates, dying with their misery unassuaged, must suffer unnecessarily because of lack of information amongst physicians, and lack of proper facilities for treatment. Likewise, our own unit and many others have extremely long waiting lists, making even more difficult the treatment of an already complex problem. In spite of this, more than 50% of patients who attend multidisciplinary pain clinics obtain long-term benefit from their therapy. The fact that facilities do not exist for many sufferers is not only disgraceful, but also very expensive both from social security payments and from inappropriate use of health care facilities as these patients wander from clinic to clinic in search of a cure which is not available. Chronic pain should be recognized for what it is--a severe and debilitating condition--and proper steps should be taken to provide the treatment within the health service for its alleviation.
authors.forename: J C
authors.initials: JC
authors.lastname: Wells
mesh_terms: D006801:Humans; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010148:Intractable Pain / Q000628:therapy