Chronic pain an update

In Germany, the prevalence of chronic pain is 17%. Persistent nociceptive signailing can modify the central nervous system similar to the neurobiological mechanisms of learning and memory that account for pathological pain sensitivity. This finding indicates that chronic pain is a disease in its own right. Somatic, psychological and social factors contribute to the development of central pain sensitization. For this reason, the decisive step of/in successful therapy is a careful evaluation of the interaction of these factors. Therefore, instead of "pain therapy" the term "pain medicine"should be preferred. Ideally, a successful outcome will be obtained by applying multinnodal approaches, including a high treatment density and an increased treatment time. While the pain relief is a major target, integrating the symptomatology in daily life is also an important therapeutic aspect. New findings of the neurobiology of chronic pain have resulted in an increasing differentiation of drug-therapies and non-medical treatments. Thus individual factors will increasingly be of interest. In the future, treatment decisions may be oriented to newly identified biomarkers.