MANAGEMENT OF CHRONIC PAIN .1.

Chronic pain is associated with substantial psychosocial and economic stress, coupled with functional loss and various levels of vocational dysfunction. The role of a pain center is to focus on chronic pain in a multidisciplinary, comprehensive manner, providing the patient with the most effective opportunity to manage his or her chronic disease sy ndrome. This article focuses on methods to manage many types of chroni c pain and describes a broad range of pharmacologic and nonpharmacolog ic interventions and options available to the patient. Part I of this two-part monograph describes pharmacotherapeutic interventions and reg ional nerve blocks. Part II focuses on psychologic assessment and trea tment and physical therapy A multimodal management strategy offers pat ients the greatest improvement potential for specific chronic pain syn dromes. Cognitive and behavioral therapies and physical therapies are described. This combination of therapies may provide patients with the skills and knowledge needed to increase their sense of control over p ain. The integration of appropriate pharmacotherapeutic regimens, neur al blockades, physical therapy, and psychologic techniques maximizes a patient's effectiveness in dealing with chronic pain. Three case stud ies are presented in Part II.