Chronic pain

The principal treatment responsibility of pain patients lies with the primary health care. Specialists are consulted with when necessary. A good treatment relationship with the own family doctor is fundamental in the treatment of chronic pain. The tasks in the primary health care include clinical examination of pain patients (history and physical examination), complemented if necessary with further tests available in the primary care, with the aim of identifying the type of pain (nociceptive, neuropathic, other) diagnosing the underlying disease causing the pain mapping of the psychosocial background factors that may contribute to the pain becoming chronic: the patient’s own view of the pain and its significance, the patient’s mood using DEPS screening, occupational and family situation, use of alcohol or drugs causal or symptomatic treatment of pain according to the local agreements concerning the division of responsibilities between primary and specialised care. Patients with moderate or severe pain that is prolonged despite treatment attempts in the primary care should be referred to specialised care. Pain is documented on every visit by using a visual analogue scale (VAS) for pain (0–10) or a numerical rating scale (NRS; 0–10). Rehabilitation is arranged for patients with poor treatment response to help with adapting to and coping with the symptoms.