ABSTRACT
Scope of pain medicine and the professions involved Chronic pain patients are a diverse group of patients. Historically, the major impetus for the establishment of specialist pain clinics was cancer pain and the development of techniques for nerve destruction, using techniques refined from specialist local anaesthetic practice. However, improvement in medical management and nursing care of cancer patients has in most cases superseded the need for techniques that prompted such specialist interest. The focus of attention of many pain clinics has thus become one of managing a condition that is usefully called a chronic pain syndrome, rather than the treatment of pain symptoms. The general hospital pain clinic manages cancer pain, nerve injury pain, chronic back problems and peripheral vascular disease. Its involvement may be for technical service reasons, such as a sympathectomy to improve blood flow to the ischaemic limb, or it may take the lead role in managing the complex medical and psychosocial problem called the chronic pain syndrome.
