General principles of pain management

In Germany an estimated 5 million people (8% of the population) suffer from chronic pain. Worldwide, the prevalence of chronic benign pain ranges between 2% and 40% of the population, depending on the study. In the USA, the rate of disability claims associated with chronic back pain has increased above the rate of population growth by 1,400%. Often these chronic pain patients have been reviewed by many physicians and have tried a variety of different treatments. They often have impaired ability to perform daily activities and have associated psychological disorders and social problems. A wide range of therapeutic options dealing with both the individual problems and biopsychosocial context of these chronic pain patients is needed. Methods and techniques used in pain therapy are constantly developed and improved. Efficacy must be reappraised frequently, ideally using the results of new multidisciplinary clinical trials or high quality meta-analyses. Physicians and psychologists working in pain therapy should have special training and experience in this field.