Summary Chronic non-malignant pain is often treated inadequately because of opiophobia. There is no scientific justification for this fear. With close monitoring and frequent controls, opioids are safe for this kind of pain. There is no scientific evidence that patients with chronic non-malignant pain are more prone to addiction or tolerance. It is also pertinent to consider that the endpoint of chronic pain treatment is not just freedom from pain but global wellbeing.
Chronic pain is a common and often underestimated, but very expensive condition.
Although chronic pain management encompasses psychological as well as drug treatment, and it is important to keep the different treatment modalities in mind, this review concentrates on drug treatment. The two kinds of pain differ in their clinical characteristics as well as in their response to ordinary analgesic drugs. Nociceptive pain often has a deep, throbbing quality, while neuropathic pain consists predominately of a burning, lancinating, paroxysmal sensation. While nociceptive pain will often respond well to weak or strong opioids, adjuvant analgesics are often required by patients with neuropathic pain. These conditions are all chronic but, in contrast to patients with cancer pain, are most likely to be associated with a normal life span.