World Pain Day is celebrated on October 19, 2015, and the period from October 19 to October 25 is China Analgesia Week. A recent survey on the status of chronic pain among Shanghai residents showed that the proportion of chronic pain among community residents was 92.8%, while among hospital outpatients, the proportion was even as high as 98.20%. The 79-year-old granny Chen had back pain a few years ago, and then the pain gradually expanded, and the numbness of both lower limbs began to appear, and the pain intensified after activity, and in the last three months she could not even walk a few steps, and it was difficult to turn over on her own in bed, so she had to be admitted to the hospital. The chronic pain should be seen in time Pain has been listed by modern medicine as the fifth vital sign after breathing, pulse, blood pressure and body temperature. Headache, toothache, back and leg pain, postherpetic neuralgia, chronic cancer pain …… everyone has experienced light or heavy, short or long “pain”. A recent survey on the current status of chronic pain among Shanghai residents showed that the proportion of chronic pain among community residents was 92.8%, while among hospital outpatients, the proportion was even as high as 98.20%. 60.40% of community residents and 58.07% of patients attending the clinic had pain lasting more than one year. Pain not only manifests itself in the physical body, but also causes great mental stress to patients. The survey showed that 34.94% of community residents and 43.73% of outpatients had varying degrees of depression. 31.25% of community residents and 24.85% of outpatients may have mild anxiety disorders. Compared to this high prevalence rate, only a small percentage of people actually find the right “pathway to care”. There is a common saying that “toothache is not a disease, but a pain that kills you”. Indeed, in some people’s minds, pain is not considered a “disease”, and when pain occurs, they think they can “bear it” and “it will be fine”, or they think “It is not useful to see a doctor. Some people have tried many treatments in many departments, but they have not gotten better effectively. Here “we urge the public that chronic pain should not be ‘tolerated’ and should be seen by a pain department in a timely manner.” October coincides with the World Pain Day and China Analgesia Week, Fudan University Hospital, East China Hospital, the director of the pain department, deputy chief physician Zheng Congjun through this newspaper to remind the public friends, now the majority of secondary hospitals have a pain department, which is the diagnosis and treatment of pain and pain disorders. Because the causes of pain and pain itself is very complex, is a multidisciplinary cross-section, so all chronic, long-term, troubled people’s health pain, can go to the pain department consultation and treatment. How to treat pain? Minimally invasive treatment is the trend At present, the treatment method of the pain department is mainly based on drug treatment, and vigorously develop in the direction of minimally invasive treatment with less damage, quicker effect and tolerable.” The 79-year-old Chen, mentioned earlier, was admitted to the hospital and underwent foraminoscopic medial branch treatment. The preoperative C-arm located the surgical site and marked the puncture point, and the puncture point was positioned with the aid of ultrasound to achieve precision, visualization, efficiency and safety, greatly reducing the risk of intraoperative puncture, and the puncture was positioned again after it was in place to ensure foolproofness. During the operation, the surgical site can be viewed directly under the foramoscope, and the lesion is clearly visible, and the nerve that controls the pain causing the lesion is directly destroyed. Intraoperative bleeding is only 10ml, and only 6 stitches are required for 6 minimally invasive sites. It has the characteristics of fast surgery, high safety, small wound and fast recovery after surgery. The day after the surgery, Granny Chen was able to walk with her son to the follow-up appointment. Chen, who had been unable to walk for three months, was able to walk again. Here “we call on the public not to ‘tolerate’ chronic pain, but to go to the pain department in time.” October coincides with the World Pain Day and China Analgesia Week, Fudan University Hospital, East China Hospital, the director of the pain department, deputy chief physician Zheng Congjun through this newspaper to remind the public friends, now most of the secondary hospitals have a pain department, which is the diagnosis and treatment of pain and pain diseases. Because the causes of pain and pain itself is very complex, is a multidisciplinary cross-section, so all chronic, long-term, troubled people’s health pain, can go to the pain department for treatment. With the development of medical treatment, more and more new technologies are being applied in the pain department to benefit patients. Next, Director Zheng shares a common clinical example of low back pain in middle-aged and elderly people for your readers. First of all, the problem of low back pain seriously affects life, mainly manifested as severe low back pain, turning pain, sitting and standing pain, and due to mobility problems, long-term bed rest of the elderly can also lead to pneumonia, venous thrombosis and other problems, which greatly affects the quality of life. Secondly, the causes of low back pain are complex and diverse, some are caused by lumbar disc lesions, some are caused by osteoporosis, some are caused by small lumbar joint diseases, myofasciitis, and even some are caused by ureteral stones and female pelvic inflammatory disease. Third, some patients cannot tolerate the traditional orthopedic methods of oral medication and surgical fixation, or the results are poor. For example, some elderly people cannot tolerate drugs or have poor drug effects due to their age and the combination of multiple chronic diseases; some elderly people are not suitable for surgery due to severe osteoporosis and other reasons, and some are not willing to undergo orthopedic surgery. For people with low back pain who meet the above factors, in the past, they can mostly only be treated by bed rest and some auxiliary physical therapy and massage, in fact, they can be better helped by minimally invasive treatment in the pain department. For example, the traditional radiofrequency treatment for small joints in the pain department uses a 1mm needle to partially destroy the nerve through ultrasound. It is effective in relieving pain, but because the nerve is thick, the partial destruction will regenerate, so the pain will come back in about three to six months. In some patients, the nerve that controls the pain is not in the usual location, so the positioning is not accurate and the treatment is not effective. Therefore, in the past, a considerable number of patients were not effectively treated simply with radiofrequency. Now the clinical use of intervertebral foraminoscopic medial branch treatment, through the foraminoscope can accurately find the nerve, whether in the original location or has been mutated, can be accurately located, in addition, intraoperative can directly see the nerve, high safety. This is now a mature technique. Director Zheng said that this minimally invasive surgical approach has a clear view, and the surgery mainly works on the peripheral nerves without entering the spinal canal, so the probability of infection is low and the efficacy is precise. It is suitable for multiple causes of persistent lower back pain in the elderly. After the operation, 80% of the pain is significantly improved, which can significantly improve the quality of life of the elderly. Of course, this is only one of the modalities in pain department treatment. There is no “best”, only “most suitable”. Only after a clear diagnosis and treatment, and according to the specific situation, we can find the right treatment for each individual, so that patients can stay away from “pain”.