title: Treatment of chronic non-cancer pain.
abstract: Chronic pain is a pervasive problem that affects the patient, their significant others, and society in many ways. The past decade has seen advances in our understanding of the mechanisms underlying pain and in the availability of technically advanced diagnostic procedures; however, the most notable therapeutic changes have not been the development of novel evidenced-based methods, but rather changing trends in applications and practices within the available clinical armamentarium. We provide a general overview of empirical evidence for the most commonly used interventions in the management of chronic non-cancer pain, including pharmacological, interventional, physical, psychological, rehabilitative, and alternative modalities. Overall, currently available treatments provide modest improvements in pain and minimum improvements in physical and emotional functioning. The quality of evidence is mediocre and has not improved substantially during the past decade. There is a crucial need for assessment of combination treatments, identification of indicators of treatment response, and assessment of the benefit of matching of treatments to patient characteristics.
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98195, USA. turkdc@uw.edu
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Turk
authors.forename: Hilary D
authors.initials: HD
authors.lastname: Wilson
authors.forename: Alex
authors.initials: A
authors.lastname: Cahana
mesh_terms: D000700:Analgesics / Q000008:administration & dosage* / Q000494:pharmacology; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy; D000529:Complementary Therapies / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000534:rehabilitation*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000700:Analgesics