Pain is a common clinical problem faced by orthopedic surgeons. If pain is not effectively controlled at the initial stage, persistent pain stimulation can cause pathologic remodeling of the central nervous system, and acute pain may develop into uncontrollable chronic pain. Chronic pain is not only a painful sensory experience for patients, but also seriously affects their somatic and social functions, prolongs hospitalization time, increases medical costs, and prevents patients from participating in normal life and social activities. In recent years, with the improvement of living standards and awareness of pain, the demand for analgesia has been increasing. Therefore, early analgesia based on clarification of etiology and active treatment of primary orthopedic diseases is an urgent issue for physicians. The management of pain covered in this recommendation refers only to the management of non-malignant, neoplastic acute and chronic skeletal muscle pain and orthopedic perioperative pain, and does not involve the diagnosis and management of their primary diseases. This article is only academic advice, the specific implementation of which still needs to be based on the patient and the specific medical situation. 1, the classification of pain According to the duration and nature of pain, it can be divided into acute pain and chronic pain. Acute pain refers to pain that is newly generated and may exist for a short period of time (less than 3 months), and pain that lasts for more than 3 months is considered chronic pain. Based on the pathologic mechanism, pain can be categorized as injury-perceived pain and neuropathic pain or a mixture of both. Injury-perceived pain is the response elicited by noxious stimulation of injury receptors, and the perception of pain is associated with tissue damage. Pain syndromes caused by peripheral or central nervous system injury or disease are called neuropathic pain. 2. Determination and assessment of pain In the process of pain diagnosis and assessment, the following conditions should be confirmed through detailed history questioning, physical examination and auxiliary examination: (1) serious conditions requiring urgent assessment and treatment, such as tumors, infections, bone fractures, and nerve injuries; and (2) psychiatric and occupational factors affecting the recovery, including: attitudes, emotions, and occupational characteristics of the pain, and so on. For the above clinical, mental and occupational factors need to be intervened and handled at the same time. 3, the purpose and principles of pain management (1) the purpose of pain management: ① to relieve or alleviate pain; ② to improve the function; ③ to reduce the adverse effects of drugs; ④ to improve the quality of life, including the improvement of the physical state, mental state. (2) Principles of pain management: should include five aspects. Emphasize health education: pain patients are often accompanied by anxiety and tension, so it is necessary to emphasize on health education and communication with them in order to get the cooperation of patients and achieve the ideal pain treatment effect. Choose reasonable assessment: For acute pain, pain assessment methods should be simple. If the degree of pain needs to be quantified, quantitative methods can be chosen. Treat pain as early as possible: once pain becomes chronic, treatment will be more difficult. Therefore, early treatment of pain is essential. For the treatment of postoperative pain, preemptiveanalgesia is advocated, i.e., analgesia is given before the onset of injurious stimuli. Advocating multi-modal analgesia: combining drugs with different mechanisms of action to exert synergistic or additive effects on analgesia, reducing the dose and adverse effects of a single drug, and at the same time improving tolerance to the drug, accelerating the onset of action and prolonging the duration of analgesia. Currently, the commonly used modes are the combination of weak opioids with acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), etc., and the combination of NSAIDs and opioids or local anesthetics for nerve blocks. However, care should be taken to avoid repeated use of similar drugs. Focus on individualized analgesia: there are individual differences in the response of different patients to pain and analgesic drugs, so the method of analgesia should be different from person to person, and should not be mechanically applied to a fixed drug regimen. The ultimate goal of individualized analgesia is to apply the smallest dose to achieve the best analgesic effect. 4, orthopedic pain management of common methods: (1) non-pharmacological treatment: including patient education, physical therapy (cold compresses, hot compresses, acupuncture, massage, transcutaneous electrical stimulation therapy), distraction, relaxation therapy and self-behavioral therapy. Non-pharmacological treatments have different therapeutic effects and precautions for different types of pain, and different treatments should be chosen according to the disease and its progress. (2) Drug therapy: Before using any drug, please refer to its instruction manual. Topical topical medications: various NSAIDs emulsions, creams, patches and non-NSAIDs rubbing capsaicin. Topical topical medications can be effective in relieving pain caused by diseases such as myofasciitis, myoadhesion point inflammation, luminal sheath inflammation, and superficial osteoarthritis and rheumatoid arthritis. Systemic drugs: ① acetaminophen, can inhibit the central nervous system synthesis of prostaglandins, produce antipyretic and analgesic effect, the daily dose of not more than 4000mg when the adverse reaction is small, overdose can cause liver damage, is mainly used for mild and moderate pain. ② NSAIDs, which can be categorized into traditional non-selective NSAIDs and selective COX-2 inhibitors, are used for mild and moderate pain or synergistic treatment of severe pain. Currently, the commonly used clinical modes of administration include oral, injection, and anal placement. NSAIDs should be selected by referring to the drug insert and evaluating the risk factors of NSAIDs. If the patient has a high risk of gastrointestinal adverse reactions, use non-selective NSAIDs with gastrointestinal protective agents such as H2 receptor blockers, proton pump inhibitors, and gastric mucosal protectors such as misoprostol, or use selective COX-2 inhibitors. When applying NSAIDs, efficacy and safety factors should be weighed in patients at high risk of cardiovascular disease. Care should be taken to avoid the simultaneous use of two or more NSAIDs.The elderly are advised to use NSAIDs with a good safety record for the liver, kidney, and gastrointestinal tract. Opioid analgesics: mainly exert analgesic effects by acting on central or peripheral opioid receptors, including codeine, tramadol, oxycodone, morphine, fentanyl and so on. The most common adverse reactions of opioid analgesics include: nausea, vomiting, constipation, drowsiness and excessive sedation, respiratory depression and so on. When opioid analgesics are used in the treatment of chronic pain, patients’ pain level should be monitored promptly in order to adjust their dosage and avoid drug dependence. Compound analgesics: composed of two or more analgesics with different mechanisms of action to achieve synergistic analgesic effect. Currently, commonly used compound analgesics include acetaminophen plus tramadol. In the compound preparation, the daily dose of acetaminophen is not more than 2000mg. Closure therapy: It is to inject a certain concentration and quantity of steroid hormone injection mixed with local anesthetic into the lesion area, such as joints, fascia and so on. Clinical application of steroid hormones is mainly to use its anti-inflammatory effect, improve the permeability of capillaries, inhibit the inflammatory response and reduce the damage of pathogenic factors on the body. Commonly used corticosteroids are methylprednisolone, dexamethasone and so on. Commonly used drugs applied to local nerve endings or around nerve trunks are lidocaine, procaine and ropivacaine. Adjuvant drugs: including tranquilizers, antidepressants, anxiolytics, or muscarinic drugs.