Chronic pain is currently under-diagnosed and under-treated, partly because doctors' training in
pain management is often inadequate. This situation looks certain to become worse with the rapidly increasing elderly population unless there is a wider adoption of best
pain management practice. This paper reviews current knowledge of the development of
chronic pain and the multidisciplinary team approach to
pain therapy. The individual topics covered include nociceptive and
neuropathic pain, peripheral sensitization, central sensitization, the definition and diagnosis of
chronic pain, the biopsychosocial model of
pain and the multidisciplinary approach to
pain management. This last section includes an example of the implementation of a multidisciplinary approach in Belgium and describes the various benefits it offers; for example, the early multidimensional diagnosis of
chronic pain and rapid initiation of evidence-based
therapy based on an individual treatment plan. The patient also receives
continuity of care, while
pain relief is accompanied by improvements in physical functioning, quality of life and emotional stress. Other benefits include decreases in catastrophizing, self-reported patient disability, and depression. Improved training in
pain management is clearly needed, starting with the undergraduate medical curriculum, and this review is intended to encourage further study by those who manage patients with
chronic pain.