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November 2003

Pain 2003

Arch Neurol. 2003;60(11):1520. doi:10.1001/archneur.60.11.1520

PAIN IS a disabling symptom. Research into its causes as well as therapies for its control remain imperfect. Chronic pain affects more than 86 million Americans and is estimated to cost $90 billion annually in reduced employment, medication expenses, and medical care.1 Clearly, progress is being made regarding the basic, fundamental physiological mechanisms responsible for pain production and the introduction in recent years of new therapeutic approaches for the treatment of neuropathic pain. In this issue of the ARCHIVES, Dworkin et al2 review new knowledge in pain diagnosis, mechanism of pain production, and treatment recommendations for neuropathic pain. Giller3 brings us up to date on the neurosurgical treatment of pain. As they point out, significant relief from chronic neuropathic pain is now both feasible and achievable, as shown by evidence-based treatment approaches with randomized controlled clinical trials.