Key messages
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Chronic pain is a pervasive health issue that exerts a substantial social and economic burden on both the affected individual and society
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Mechanisms underlying chronic pain include a complex interaction of physiological, emotional, cognitive, social, and environmental factors
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Treatment options include pharmacological approaches; interventional techniques including nerve blocks, surgery, implantable drug-delivery systems, and spinal-cord stimulators; exercise and physical rehabilitation; psychological treatments; interdisciplinary treatment; and complementary and alternative treatments
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In view of the complex nature of chronic pain, treatment often necessitates use of a blend of different approaches
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Overall, present treatment options result in modest improvements at best, and part of chronic pain management should include dialogue with the patient about realistic expectations of pain relief, and bring focus to improvement of function