In the acute situation, pain is a protective mechanism as a result of physical insult or injury. Conversely, chronic pain syndrome causes both physiological and psychological derangement. The principle in pain management includes detailed history and physical examination. Detailed history includes onset, location, frequency, duration of the pain, aggravating as well as alleviating factors. Sleep disturbance is a major cause of depression, functional impairment and can cause disruption of life.
Neural blockade is one of the diagnostic tools frequently used.
It is also a tool for therapy as well as prognosis prior to the neurolytic procedure. Understanding the indications for neural blockade is as important as interpreting the result obtained from the procedure. Once the diagnosis is established, a therapeutic plan can be formulated. Medical therapy is usually the initial management for both cancer and non-cancer pain. However, one should bear in mind the limitation of medical modality.