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Chronic nonmalignant pain: a challenge for patients and clinicians

Nature Clinical Practice Rheumatology volume 4, pages 74–81 (2008)Cite this article

Abstract

Chronic pain is widely regarded as a condition that is triggered by various factors, including physical, socio-cultural and psychological deficiencies (that is, maladaptive beliefs). These factors are important in the development and maintenance of this unpleasant experience, which consequently requires a biopsychosocial treatment approach. Pain is a multifaceted sense, the perception of which is personal. Pain also depends on various circumstances, and therefore represents a challenge for the patient, as well for the treating physicians. Patients who suffer from long-lasting pain with a predominantly psychosocial component should be referred to specialized pain clinics for further diagnostic assessment and possible allocation to multidisciplinary pain programs. High-quality randomized controlled trials indicate that multidisciplinary pain programs represent the best therapeutic option for the management of patients with complaints associated with complex chronic pain. The prevalence and the costs—both direct and indirect—that are attributed to chronic pain are increasing; however, not enough is being done to sufficiently and effectively treat chronic pain. There is, therefore, a need for well-designed, interdisciplinary, internationally comparable, and widely distributed pain programs, both in outpatient and inpatient settings, to contribute to the prevention of some future pain diseases.

Key Points

  • A multidisciplinary approach to treating pain represents a valid, evidence-based treatment modality for patients with chronic pain

  • Multidisciplinary pain programs should ideally involve a physician, a physiotherapist, a psychologist, an occupational therapist and a social worker to cover the main areas of treatment of chronic pain based on the biopsychosocial model of illness

  • The primary aims of pain programs are to improve the health-related quality of life and to teach the patient how to accept and cope with pain

  • Pre-existing psychological vulnerabilities and high psychosocial distress should be considered in the comprehensive assessment of patients with chronic pain before embarking on a pain management program

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Author information

Authors and Affiliations

  1. L Scascighini is a Research Associate in the Department of Rheumatology and Institute of Physical Medicine, and a Lecturer at the Department of Health of the University of Applied Sciences of Southern Switzerland., University Hospital Zürich, Switzerland,

    Luca Scascighini

  2. H Sprott is Senior Attending Physician and Head of Pain Research at the Center of Experimental Rheumatology in the Department of Rheumatology and Institute of Physical Medicine, University Hospital Zürich. He is a Privatdozent of the University of Zürich.,

    Haiko Sprott

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  1. Luca Scascighini
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  2. Haiko Sprott
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Correspondence to Luca Scascighini.

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Scascighini, L., Sprott, H. Chronic nonmalignant pain: a challenge for patients and clinicians. Nat Rev Rheumatol 4, 74–81 (2008). https://doi.org/10.1038/ncprheum0680

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