Analgesics in the management of chronic pain. Part One: general principles.

This article is the first in a series of five reviewing the management of chronic, intractable pain which is invariably associated with malignant or wasting disease. Audits continue to show that pain of this type is often poorly controlled, despite the availability of effective treatments and the fact that it is perceived by patients as one of the most distressing aspects of their illness. The first article covers the general principles which underly pain management, including the concept of the Analgesic Stepladder.