Importance of effective pain control.

Although the scientific study of pain in the modern sense was initiated 150 years ago, and a number of theories were subsequently proposed, until two decades ago pain research remained conceptually stagnant and the meager amount done was not commensurate with the magnitude and clinical importance of pain. Consequently, pain treatment remained somewhat empirical and ineffective. Moreover, the knowledge and effective therapeutic modalities that were available were not properly applied, primarily because medical students and physicians were not taught the basic principles of pain management. Fortunately, during the past 20 years significant advances have been made in our knowledge of basic mechanisms of acute pain and about some chronic pain syndromes, and a variety of new therapeutic modalities have been introduced and old ones have been refined. Among the most important advances of the past decade have been the discovery of opiate receptors, the extensive pharmacokinetic and pharmacodynamic studies of narcotics, the development of very sensitive analytic techniques and mathematic knowledge and many other advances which have prompted the development of new drugs, novel drug preparations and novel methods of administration, of which intraspinal narcotic therapy is the most important and widely used.