Treatment of nonmalignant chronic pain

Nonmalignant, chronic pain is associated with physical, emotional and finan cial disability. Recent animal studies have shown that remodeling within th e central nervous system causes the physical pathogenesis of chronic pain. This central neural plasticity results in persistent pain after correction of pathology, hyperalgesia, allodynia. and the spread of pain to areas othe r than those involved with the initial pathology Patient evaluation and man agement focus on pain symptoms, functional disabilities, contributory comor bid illnesses, and medication use or overuse. Treatment of chronic pain inv olves a comprehensive approach using medication and functional rehabilitati on. Functional rehabilitation includes patient education, the identificatio n and management of contributing illnesses, the determination of reachable treatment goals and regular reassessment.