Pain Management

Ronald Kanner, MD
JAMA. 1986;256(15):2112-2114. doi:10.1001/jama.1986.03380150122040.
Text Size: A A A
Published online

Three major areas have advanced in our management of pain patients: (1) better syndrome definition, (2) clearer scientific basis for the use of analgesic medications, and (3) correct utilization of pain centers.

Acute pain1 is linked in time, location, and severity to an underlying lesion. Chronic pain can be divided into nociceptive (related to tissue injury) and non-nociceptive (deafferentation and psychogenic).2Nociceptive pain is the most common type in cancer and other medical illness. It most often responds to treatment of the underlying cause or to standard analgesic medication. Deafferentation pain3 is due to nervous system injury that interrupts the normal transmission of sensory impulses. Pain is ill-defined, burning, and dysesthetic and may have a component of sympathetic dysfunction with wasting, color changes, shiny skin, decreased temperature, and hair loss. If the sympathetic component is prominent, sympatholytic procedures may be indicated. Reflex sympathetic dystrophy and postherpetic neuralgia


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.