A Contemporary Approach to Chronic Pain Management

Abstract

Chronic pain has traditionally been defined mainly by duration. That definition explains little about why patients with similar diagnoses differ in disability and treatment response. A contemporary approach shifts focus to the underlying pain mechanism. ICD-11 supports this shift by separating chronic primary from chronic secondary pain. Management follows the same logic: rigid analgesic escalation gives way to multimodal, individualized treatment guided by function and patient goals. Personalized analgesia, including pharmacogenomics, extends this individualization further, though its role remains supportive rather than decisive. This review outlines this mechanism-based, patient-centered shift as an alternative to the traditional duration-based model.