Management of Chronic Pain

Chronic pain defined as pain that persists beyond the period of healing, in the absence of ongoing pathology, usually means pain over 3 to 6 months after the cure of the original disease. In this situation, the pain itself loses its protective function only to fall into a disease entity. There have been many efforts to treat chronic pain, with analgesics being the most commonly used modality, which include non-steroidal anti-inflammatory drug, opioids, antidepressant, and anxiolytic agents. Pain clinicians especially use nerve blocks for the control of intractable pain. Although the effect of nerve block or trigger point injection with local anesthetics is temporary, its effect of breaking the vicious cycle of pain patheway gives a long-term effect of analgesia. There are many diseases managed at pain clinics, including headache, trigeminal neuralgia, neck and shoulder pain, low back pain, complex regional pain syndrome, herpes zoster and postherpetic neuralgia, fantom pain, peripheral neuralgia, and vascular disease. The main nerve indicated for pain control may be any kind of somatic and sympathetic nerves and ganglions responsible for the pain.