ABSTRACT
The medical model should be replaced by a biopsychosocial model, thereby acknowledging that psychosocial features may be more important risk factors for chronicity and disability than biomedical symptoms and signs. Chronic pain syndromes are complex to treat, and treatment may be extensive and require many resources. The high prevalence rates of major depression, anxiety syndromes, and substance and alcohol abuse and personality disorders in the group of patients with chronic pain may influence the treatment strategy. The use of opioids in chronic non-malignant pain states is widely disputed in Western medicine. Most physicians should co-operate with a pain clinic if opioids are considered for non-malignant chronic pain states. The neurogenic origin of both chronic pain and myofascial pain syndromes is probably common. There is increasing evidence that the choice of treatment for fibromyalgia and other chronic pain syndromes is multidisciplinary programs. There are many hypotheses concerning the relationship between working conditions and development of chronic pain.
