ABSTRACT
A comprehensive description of the pain will aid in allowing an assessment as to its seriousness as well as the need for medical intervention. Effective analgesia should be attempted with the weakest analgesic able to relieve the pain, associated with the least side effects. Analgesics divided into three groups; the nonnarcotic or peripherally active analgesics and the antidepressants for neuropathy comprise the first step of treatment; the centrally acting analgesics comprise the second step; and increased doses of more potent opioids used as the pain becomes more severe. The use of placebos in the treatment of pain is often accompanied by greater risks than benefits and seriously affect the patient-physician relationship. Finally, persons with chronic pain syndromes have often experienced such frustration in negotiating the health care system without obtaining relief that they are predisposed to believe that physicians never take their complaints seriously, especially when their analgesic requirements are greater than usual due to the development of tolerance.
