Charles E. Argoff, MD Professor of Neurology Albany Medical College Director Comprehensive Pain Center Albany Medical Center Albany, New York
	Paul P. Doghramji, MD Attending Physician Pottstown Memorial Medical Center Pottstown, Pennsylvania Senior Staff Member Collegeville Family Practice Medical Director of Health Services Ursinus College Collegeville, Pennsylvania Preceptor in the Physician Assistant Program Arcadia University Glenside, Pennsylvania
	Christopher Gharibo, MD Associate Professor of Anesthesiology and Orthopedics Medical Director of Pain Medicine NYU Langone-Hospital for Joint Diseases New York, New York
	David M. Kaufman, MD CME REVIEWER Professor of Neurology and Psychiatry Albert Einstein College of Medicine Bronx, New York

This CME activity is intended to improve the assessment, diagnosis, and long-term management of patients with chronic pain. Guided by comprehensive assessment of educational needs, each module within the Interactive FORUM™ will provide a forum for healthcare professionals to increase their scientific and clinical knowledge around chronic pain management.

This Interactive FORUM™ is a self-guided, multimedia educational program that engages clinicians with a dynamic mix of live faculty presentations and iPod touch-enhanced posters and case studies.

In high-definition video, faculty will explore the underlying mechanisms and progressive pathophysiologic changes associated with chronic pain, including implications for diagnosis and treatment.		Faculty will demonstrate practical techniques in the diagnostic workup of patients with chronic low back pain or neuropathic pain, and discuss evidence-based treatment strategies to improve patient function.		Participants will apply their clinical judgment at key decision points during video case presentations illustrating best practices in the assessment and long-term management of chronic pain.

Chronic pain is a heterogeneous disease state that often defies simple classification, diagnosis, and treatment. Characterized by hyperactive nociceptive pathways and associated with numerous pathologic conditions, chronic pain affects an estimated 116 million adults in the United States with significant socioeconomic consequences.¹ Although the precise determinants of chronicity have not been fully elucidated, the neuroplastic changes associated with chronic pain are thought to be progressive and often irreversible, underscoring the need for thorough assessment, timely diagnosis, and aggressive treatment.² Importantly, the clinical presentation of chronic pain is markedly influenced by patient-specific biologic and psychosocial parameters, requiring comprehensive evaluations of all contributory factors and functional deficits associated with the pain experience.³ Advances in our understanding of pain mechanisms, improved assessment methodologies, and a growing evidence base supporting various therapeutic approaches have left clinicians better equipped to manage the growing population with chronic pain.^4-7 This Interactive FORUM™ highlights recent scientific insights into pain pathophysiology and how they can be translated into practical chronic pain assessment and management strategies.

REFERENCES

1.	Institute of Medicine of the National Academies. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: Institute of Medicine of the National Academies; 2011.
2.	Woolf CJ. Central sensitization: uncovering the relation between pain and plasticity. Anesthesiology. 2007;106:864-867.
3.	Gatchel RJ, et al. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007;133:581-624.
4.	Baron R, et al. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol. 2010;9:807-819.
5.	American Society of Anesthesiologists. Practice guidelines for chronic pain management: an updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology. 2010;112:810-833.
6.	Chou R, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-491.
7.	Smart KM, et al. The discriminative validity of "nociceptive," "peripheral neuropathic," and "central sensitization" as mechanisms-based classifications of musculoskeletal pain. Clin J Pain. 2011;27:655-663.

After completing this activity, participants should be better able to:

• Assess chronic pain phenomenology, including pain characteristics, associated symptomatology, functional consequences, and underlying neurobiologic mechanisms
• Perform initial and ongoing evaluations of patients with chronically painful conditions, including low back pain, osteoarthritis, peripheral neuropathies, and other pain syndromes
• Evaluate the clinical profiles of pharmacologic agents based on analgesic mechanisms of action, potential benefits, adverse effects, and risks of inappropriate use
• Tailor single-agent and multidrug pharmacologic regimens for chronic pain to maximize analgesia and functional gains and minimize adverse effects
• Implement and coordinate multidisciplinary care to address the full range of biopsychosocial symptoms associated with chronic pain

This Live activity, Coordinating Evidence-Based Care for Chronic Pain, with a beginning date of October 17, 2012, has been reviewed and is acceptable for up to 1.50 Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Conflict of Interest Disclosure Policy of Educational Review Systems requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical product or device company. Presenters whose disclosed relationships prove to create a conflict of interest with regard to their contribution to the activity will not be permitted to present.

Educational Review Systems also requires that faculty participating in any CME activity disclose to the audience when discussing any unlabeled or investigational use of any commercial product or device not yet approved for use in the United States.