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Pain is an unpleasant sensory and emotional experience. It is recognized as a complex phenomenon derived from sensory stimuli and modified by individual memory, expectations, and emotions. Unfortunately, therf; are no objective biological markers of pain. The most accurate evidence of existence of pain and its intensity is the patient´s description of it. Chronic pain is a major public health problems, inflicting not only tremendous personal suffering, but also huge economic loss on individuals and society. If the pain remains intractable, physicians and patients became increasingly uncertain as to the most appropriate course of treatment, and both develop a sense of helplessness. As each becomes frustrated and disap-pointed in the other, their interaction becomes more strained and less direct:. But, in the future, much more is known of the mechanisms and pathophysilogy of pain, we can manage the pain more effectively. Concepts of Pain The word pain is derived from the Latin word poena, meaning fine or penalty. The International Association for the Study of Pain has described pain as an unpleasant sensory and emotional experience primarily associated with tissue damage and/or described in terms of such damage. The sensation of acute pain is familiar to everyone and is one of the earlist and common symptoms of disease. Pain is the number one reason that patients seek medical attention. It is an alarm mechanism warning of tissue damage and potential danger. However, chronic pain is a unique sensory experience. Patients who to successful management of chronic pain. Doubting of the complaint has no therapeutic benclit. Instances in which the patient cannot be believed ~u~e rare. Treat any pain aggressively and as early as possible. Treating pain early may avoid the structural-functional changes in the nervous system that lead to chronic pain. The psycho-ogic issues associated with the patient´s pain must be incorporated into the management plan. Some of these issues are depression, fear, interpersonal relationships, financial need compensation, and disability. The patient needs to understand that these psychologic factors can influence the intensity and tolerance of pain. It is essential to establish appropriate goals before initiating treatment. A complete "cure" is not a realistic goal, but a reduction in the parient´s level of pain with improvement in functional status is a realistic goal. Factors that influence pain, such as depression, physical inactivity or regression, drug addiction, and emotional regression, can be treated.
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