The goal of treatment is to: 1) eliminate pain when possible; or to 2) manage pain and restore function when eliminating the pain is not possible. Typical first-line treatments include rehabilitation, pharmacological analgesics, adjuvant therapies, and alternative/complementary treatments. Psychological therapies, surgical/anesthetic techniques, and a formal multidisciplinary approach may be necessary in select cases. Pain physicians are also frequently requested to comment on and certify disability.

The multidisciplinary approach – Given the varied impairments in the physical, psychological, social, and vocational domains due to pain, a multidisciplinary approach to management is frequently advocated for and has been generally supported by the peer-reviewed literature, although the quality of the supportive literature has not typically been high-grade. In 1992, Flor, et al., published a metanalysis of 56 studies showing an advantage of multidisciplinary care in terms of pain control, return to work, and healthcare utilization over individual treatment with medication management or physical therapy alone. The authors stated, however, that the quality of the study designs reviewed was “marginal” and that further research was necessary.

More recent literature has improved in design quality but has shown somewhat equivocal results. A 2005 Swedish study (Jensen)

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