%0 Journal Article
%T The Pain Crisis: What It Is and What Can Be Done
%A Barry J. Sessle
%J Pain Research and Treatment
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/703947
%X Chronic pain is present in epidemic proportions in most countries, is often unrelieved, and has a huge socioeconomic impact. It is not just a ¡°medical¡± illness but indeed is a problem that faces all healthcare professional fields. Several steps are identified to address this crisis. These include approaches to enhance pain awareness and access to timely and effective care for pain, and educational and research approaches to improve the knowledge base of healthcare professionals and students and diagnostic and management procedures for pain. Several opportunities to enhance pain understanding, access, and management are also identified. 1. Introduction Despite recent advances in our understanding, diagnosis, and management of pain, several problems confront the pain field, especially in the case of chronic pain which remains a public health problem of epidemic proportion in most countries. This is largely due to the limited levels of (a) awareness of pain, particularly its socioeconomic impact and burden, and access to timely and appropriate care, (b) pain education, especially of health professionals, and (c) research into pain mechanisms and into ways to improve diagnostic and management approaches and healthcare delivery. This pain crisis has been highlighted over the past 2 decades by several authors and again recently by the recent report in the USA by the Institute of Medicine (IOM) [1¨C7]. This article will focus on these areas and provide for each some possible means to address the current crisis of chronic pain. 2. Awareness of Pain and Its Impact Pain is a subjective individual experience encompassing sensory, cognitive, emotional, and social dimensions. One person may report a moderate level of pain following an injury while another person with a similar injury may report a much higher, or lower, pain level. This individual-by-individual experience of pain depends on numerous features that include each person¡¯s unique genetic features and cognitive, motivational, emotional, and psychological state as well as environmental factors stemming from their gender, past experiences and memories of pain, cultural and social influences, plus their general health condition. Pain does serve an important vital function as a warning signal of tissue damage, resulting from an accidental trauma, infection, or inflammation, for example. It usually disappears after the injured tissue has healed. In contrast to such acute pain episodes, chronic pain is usually considered as having no biological role but is associated with changes in the peripheral and central
%U http://www.hindawi.com/journals/prt/2012/703947/