Management of pain

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Abstract
Methods The topics we have chosen result from discussions with all grades of staff involved in the management of acute and chronic pain and range from new drug development based on scientific evidence that may impact on future pain management to a holistic approach to patient care. Our searches focused on the key words “pain,” “systematic review,” “management,” and “neuropathic.” We searched Medline, the Cochrane Library, and Health Technology Assessments, and we scrutinised the BMJ and the National Institutes of Health websites as well as professionally based websites for pain, such as that of the International Association for the Study of Pain and scientific websites such as that of the National Academy of Sciences. We identified systematic reviews from the past three years from these sources and leading scientific papers. Recent developments A major change in pain management is a move from empirical therapies to a mechanism based approach New drug developments are targeting specific receptor subtypes Pain assessment includes qualitative sensory affective and quantitative sensory testing to improve subgroup analysis and evidence based treatment of heterogeneous disease states Care is individualised, holistic, and organised through a multidisciplinary approach

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