Abstract
Chronic pain is perceived by physicians and healthcare systems
worldwide as a major challenge, costing US $650 billion per year,
which is more than the costs of cancer, cardiovascular diseases, and
diabetes [1]. Despite major efforts to find cost-effective solutions,
these efforts are heading in the wrong direction. Worldwide, chronic
pain-associated knowledge and pain practices are dissociated,
and approaches to diagnosis and treatment are mostly based on
outdated knowledge and are highly reductionist. Research, medical
education, legislation priorities, and directions are influenced by
economic dominance, and chronic pain clinical practices, for a
significant majority, are going against medical ethics, evidencebased medicine, and cost-effectiveness. In USA, chronic pain
patients are misdiagnosed 40-80% of times according to research
from John Hopkins Hospital physicians [2]. Over the past 30 years
to date, a huge body of research evidence from the perspectives
of conventional pain medicine, complementary/integrative pain
medicine, and regenerative pain medicine has not been incorporated
into chronic pain medical education/training. Therefore, an extensive
and comprehensive 30-month clinical fellowship training program
was created at McMaster University in Canada (2007–2010) to fill
these gaps. Its main outcome is a major shift in pain management
goals from extremely costly, unsafe pain relief to the cost-effective
treatment or curing of most chronic pain syndromes and their
underlying causes.