Pain affects everyone at one time or another. Many diseases and disorders of the human body are accompanied by pain. It is feared by many people, as much as or more than the disease itself. What is pain? What purpose, if any, does it serve? What happens in the body when a person feels pain? How is pain assessed? What are the different types of pain? Can pain be treated? If so, how? These are some of the questions addressed in this chapter.
Pain is an expanding science, and an increasing number of specialty clinics are emerging. The International Association for the Study of Pain (IASP) identifies the following four models for pain treatment:
- Single service clinics are normally outpatient clinics providing specific pain treatment with the goal to reduce pain. These do not provide comprehensive assessment or management. Examples include a nerve block clinic and a biofeedback clinic.
- Pain clinics also are outpatient, but their focus is mainly on diagnosis and management of individuals with chronic pain. These might focus on such specific pain issues as back pain or headache but also can provide treatment for general pain conditions.
- A multidisciplinary pain clinic may be inpatient or outpatient and includes specific treatment. These provide services from different healthcare professionals who can assess and manage physical restoration or rehabilitation and medical needs and provide educational and psychological services.
- A multidisciplinary pain center is usually found in a medical school or teaching hospital. The pain center provides the most complex model for managing and treating pain. Pain centers also engage in research. Two of the earliest multidisciplinary pain centers were the University of Washington in Seattle and the City of Hope Medical Center in Duarte, California.