Where We Come From and Are We Aware of Where We Are Going To?

Abstract

Chronic pain is a pathological condition that requests specific medical attention. Its treatment has been imperative since the origin of our species, taking advantage of herbs and natural remedies available in the primitive environment. Morphine has stood the test of time as has been continuously used for the past 8 millennia. The anatomical knowledge of the nociceptive sensation pathways led to the introduction of some surgical techniques directed to stop this pain transmission. Due to their aggressiveness and to the fact that they are irreversible, these techniques were soon replaced by neurostimulation procedures. Being reversible and allowing a change in stimulation parameters soon became the preferred treatment strategy. Over the years a small subset of patients continues to suffer from chronic pain refractory to the usual neurostimulation and pain-controlling medications. These patients can perhaps benefit from one of the surgical ablative procedures. Some of these techniques have been proven particularly effective throughout the years. For some limited income patients in underdeveloped countries, these techniques may be their only accessible option. Doctors have to keep in mind these surgical techniques to put them at the service of our patients in the very few cases in which they are needed. Letting these ablative techniques to die in oblivion would be a disservice to our patients.