title: Recent advances in understanding pain mechanisms provide future directions for pain management.
abstract: OBJECTIVE
  To review current knowledge of neurobiologic mechanisms that generate and maintain chronic pain and to explain how they might be applied in targeting treatment of chronic, inflammatory, and neuropathic pain syndromes.
  
  
  METHODS
  Published research, literature review articles, and abstracts as well as national statistics.
  
  
  RESULTS
  Treatment for chronic pain associated with cancer and other syndromes remains suboptimal and falls significantly short of clinical needs. Data highlight the role that multiple neurobiologic mechanisms play in modulating and maintaining pain at various levels of the central and peripheral nervous systems. Novel agents have been developed that use a more targeted approach to treating chronic pain.
  
  
  CONCLUSIONS
  A growing body of evidence highlights the critical role that neurobiologic mechanisms play in the initiation and maintenance of chronic pain. A thorough understanding of these mechanisms ultimately may result in targeted treatment approaches that focus on the central and peripheral mechanisms involved in mediation of chronic, inflammatory, and neuropathic pain syndromes.
  
  
  CONCLUSIONS
  A majority of patients undergoing active treatment for cancer experiences unrelieved pain. By gaining a better understanding of the mechanisms that generate and maintain chronic pain, oncology nurses can promote targeted pain management strategies that incorporate novel therapeutic agents.
authors.affiliation: Department of Physiological Nursing, University of California, San Francisco, USA. chris.miaskowski@nursing.ucsf.edu
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
mesh_terms: D000208:Acute Disease; D000700:Analgesics / Q000627:therapeutic use; D002908:Chronic Disease; D005544:Forecasting; D006801:Humans; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D059408:Pain Management
chemical_list: D000700:Analgesics