Recent advances in understanding pain mechanisms provide future directions for pain management

Purpose/Objectives: To review current knowledge of neurobiologic mechanisms that generate and maintain chronic pain and to explain how the migth be applied in targeting treatment of chronic, inflammatory, and neuropathic pain syndromes. Data Sources: Published research, literature review articles, and abstracts as well as national statistics. Data Synthesis: Treatment for chronic pain associated with cancer and other syndromes remains suboptimal and fall significantly short of clinical needs. Data highlight the role that multiple neurobiologic mechanims play in modulating and maintaining pain at various levels of the central and peripheral nervous systems. Novel agents have been developed that use a more targeted approach to treating chronic pain. Conclusions: A growing body of evidence highlights the critical role that neurobiologic mechanisms play in the intiation and maintenance of chronic pain. A thorough understanding of these mechanisms ultimately may result in targeted treatment approaches that focus on the central and peripheral mechanisms involved in mediation of chronic, inflammatory, and neuropathic pain syndromes. Implications for Nursing: A majority of patients undergoing active treatment for cancer experiences unrelieved pain. By gaining a better understanding of the mechanisms that generate and maintain chronic pain, oncology nurses can promote targeted pain management strategies that incorporate novel therapeutic agents.