Chronic pain is pain that lasts a long time. In medicine, the distinction between acute and chronic pain is sometimes determined by an arbitrary interval of time since onset; the two most commonly used markers being 3 months and 6 months since onset, though some theorists and researchers have placed the transition from acute to chronic pain at 12 months. Others apply acute pain that lasts less than 30 days, chronic pain of more than six months duration, and subacute to pain that lasts from one to six months. A popular alternative definition of chronic pain, involving no arbitrarily fixed duration, is “pain that extends beyond the expected period of healing”.

In spine and musculoskeletal cases, pain management serves a variety of purposes. Pain management is usually distinguished from surgical treatment.

Pain management and the techniques it uses may be employed as follows:

1. To help identify the source of a patient’s back pain
2. As an alternative to surgery, as part of an aggressive conservative (nonsurgical) care program
3. To help determine the areas to be addressed surgically
4. To help rehabilitate the patient after surgery
5. For patients after surgery to cope with residual or recalcitrant pain

Pain management uses a wide variety of techniques to address pain and painful disorders. The scientific basis for these approaches ranges from those that are completely without experimental support to those whose effectiveness has been well demonstrated in clinical trials.

In view of the diverse uses and methods of pain management and pain medicine, an overview of this fast-developing field is needed.