LAUSR

Chronic pain (CP) is a frequently encountered phenomenon with considerable psychosocial and socioeconomic consequences. Within the scope of a telephone survey, data from 15 European countries and Israel demonstrated a prevalence of CP of moderate to severe intensity in 19% of the participants. In every fifth patient the pain lasted for more than 20 years. CP affecting approximately 30% of the US population has been recognized to have significant implications for the nation’s health and economy. The most common types of CP include low back pain, osteoarthritis, headache, and neuropathic pain. Lower back and neck pain was the leading cause of disability not only in high-income but also in lowand middle-income countries. Migraine and tension-type headache affected more than 10% of theworld’s population. Treatment for patients suffering fromCP was often evaluated as being inadequate and waiting times for installment of adequate treatment were on the order of many months or years, even in wealthy countries. The surveys did not provide information as to whether and to what extent, more complex treatment strategies, such as multicomponent programs were offered. There is growing evidence that patients with a CP-disorder require a treatment structure that consists of a broad range of components as provided in interdisciplinary multimodal pain therapy (IMPT) (Fig. 1). This can be achieved by inpatient, dayclinic, and outpatient settings (eg, primary care-based interdisciplinary approach) and usually requires cooperation of several disciplines and professions. Although the basic components of IMPT have been defined by IASP, there are major gaps in knowledge that hinder its global implementation. Because of lack of resources, national policies, and attitudes among health care professionals, facilities for pain management including IMPT-programs are grossly inadequate or nonexisting in many developing countries. The aim of this topical review is to highlight the conceptual backgrounds and problems because of incongruent definitions of IMPT. A standardization of such programs (eg, therapeutic procedures/aims) is needed for research purposes to perform comparative clinical trials and meta-analyses. The outcome of such a program of research will define the role of IMPT in the treatment of patients suffering from CP.