There has been a wealth of research into what causes pain. It is a symptom or warning of an underlying medical problem. Researchers can describe in detail how the sensation is transmitted from its source to the brain so we become aware of the problem and can take action to treat it. Unfortunately, despite our better understanding of what it is, actually relieving the pain remains a challenge. If we are dealing with a non-fatal physical injury, we can set the broken bones, stitch up the wounds and wait for the body to repair itself. During this time, the pain management choices for doctors focus on the various side effects of the medications, the interactions between medications, etc. If the pain becomes more acute due to a terminal condition, the issues of addiction and, to some extent, adverse side effects are less relevant. The humanitarian need is to make a person as comfortable as possible during the final period of life. But long-term neuropathic pain represents a completely different set of challenges. (more…)