Review Article
The Pain Crisis: What It Is and What Can Be Done
Table 1
Recent advances in pain research and management.
| (i) Identification of peripheral and central nociceptive processes involving nonneural as well as neural mechanisms | | (ii) Discovery of several endogenous neurochemicals and intrinsic pathways in the brain and their influences on nociceptive | | transmission and behaviour | | (iii) Development of concepts and insights of the neuroplasticity of pain processing that can lead to chronic pain | | (iv) Rapid advances in the fields of brain imaging, biomarkers, genetics, and molecular biology as well as their applicability to the pain field | | (v) Recognition of the multidimensionality of pain and importance of biopsychosocial factors in pain expression and behaviour | | (vi) Improvements in surgical, pharmacological, and behavioural management of pain: | | (a) more effective and varied drug-delivery systems | | (b) broader range of analgesics and other drugs for management of pain and related conditions | | (c) spinal cord and brain stimulation, transcutaneous electrical nerve stimulation | | (d) physical/rehabilitative medicine | | (e) new or improved surgical approaches | | (f) cognitive behavioural therapy | |
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