La Revue du praticien
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The major development of experimental and clinical pain research over the last two decades should result in the development of new treatment strategies. In the future, the management of chronic pain should rely both on new molecules targetting specific pathophysiological mechanisms and new non pharmacological approaches, such as non invasive transcranial magnetic stimulation, acting on endogenous pain modulatory systems. The variety of new treatment options should allow a more efficacious management of chronic pain, taylored to each patient's profile.
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The pharmacological treatment of chronic pains induced by an excess of nociception is mainly based on analgesics which are classified according to their pharmacological nature (not opioid/opioid) and to their power according to the three World Health Organization steps. Their use is founded on a strategy which differs from the nature of pain (cancer pain vs no cancer pain), in particular with regard to the use of the strong opioids.