Chronic non-malignant pain

■Chronic pain affects about 20% of the adult population, with about 10% becoming significantly disabled by it. The social, economic and health care burdens related to chronic pain are enormous. ■CNS plasticity is increasingly recognised as playing a role in the development of persistent pain states. The development of postural abnormalities, physical deconditioning and psychological distress then further add to the maintenance of chronic pain. ■Chronic pain is typically categorised as neuropathic, nociceptive or a mixture of both. ■The use of brief self-report questionnaires can add valuable clinical information regarding pain intensity, mood, pain disability and pain beliefs. ■Opioid prescription should be done with specific pain reduction and functional upgrading goals at the outset. ■Group-based CBT has the strongest empirical basis in terms of increased function and decreased distress.