History of the School

Director's Welcome

The school was founded in 2009 through the joint initiative of the then President of EFIC, Professor Giustino Varrassi, and the Italian Councillor of EFIC, Dr. Roberto Casale. During the EFIC Councillors’ meetings and the many friendly discussions among the Councillors, some hot points always remained on the table as unsolved basic issues that in some way preceded the pivotal and final goal of pain medicine i.e. how to treat patients with chronic pains.

The United Nations’ Universal Declaration of Human Rights in 1948 (Article 5) states that: "No one shall be subjected to torture or to cruel, inhuman or degrading treatment". A commentary has recently been added to this statement: “Deliberately ignoring a patient's need for pain management or failing to call for specialized help if unable to achieve pain relief may represent a violation of Article 5”. Thus failure to provide access to pain management violates the United Nations 1961 Single Convention. The implicit question arising from this regrettably ignored statement was the starting point of many discussions between Professor Varrassi and Dr. Casale: as a Scientific Society devoted to the study and treatment of pain are we in some way violating this statement? The discussion immediately involved the EFIC Executive Board members Professors Eli Alon and Nevenka Krčevski Škvarčalong with the EFIC Past-President Serdar Erdine and the, at that time, President-Elect, Professor Hans Kress and can be encapsulated in this question: “As a Scientific Society how can we help to guarantee the best available diagnostic and treatment procedures on an equal basis to all EU citizens, streamlining them to the perceivable and widespread reduction in the budgets of the various national health services?”. The answer was to create instruments to improve the diagnostic and, subsequently, the therapeutic skills of doctors.

The challenge was great as it had to take into account the increasing number of doctors from different branches of medicine involved in the diagnosis and treatment of chronic pain, the lack of uniformity in the clinical approach to patients due to the different uses and availability of the various diagnostic tools, and also the different linguistic and cultural differences between countries of the European Union (EU). Indeed within an enlarged EU community and respecting the rights of all European citizens to receive adequate and uniform treatments all over Europe, there must be a minimum common denominator in the clinical and therapeutic approaches which are not always tailored for the diagnosis of “pain as a disease”. Within the frame of competence and the possibility of a Scientific Society in 2009 the proposed concrete solution was to create a new School.

The EFIC Neuropathic Pain School was launched in October of the same year during the European Week Against Pain. In October 2015, the Pain School moved to Bergamo at Habilita Care and Reseach Hospitals.

 

Dear Friends,

On behalf of the President of Habilita, Care and Reseach Hospitals, which hosts the School in its medical center in Bergamo, as well as on behalf of the EFIC President and the Executive Board of EFIC, I welcome not only the participants of the EFIC Bergamo Neuropathic Pain School but also all those who, interested in the diagnosis and treatment of chronic pain, are reading these pages.

Traditionally, the treatment of pain remains firmly in the hands of specialists in anaesthesia, however in recent years the impression has strengthened that we should go back to thinking of pain as an aspect “of the nervous system” and, therefore, that we should almost take a side-step from to treat pain as a single entity i.e. its intensity, and re-think pain in term of physiopathology of the nervous system: is the “pain generator” there, where the patient feels pain; can symptoms and signs tell us about pain mechanisms; how can we use semeiotics and the clinical and instrumental diagnosis of pain to better tailor treatments?

The School therefore only deals with aspects of clinical and instrumental neurological diagnosis, taking for granted those notions of anatomy and physiology that are the common knowledge of all those who want to deal with pain.

Much space will be given to clinical examinations of patients that generously will participate to the practical sessions. Furthermore, the structure of the school enables a direct relationship, outside the educational activities, with the Board of Teachers with whom you can debate and exchange views. The School will also give ample space to fundamental issues of clinical methodology such as how to differently approach in- and out-patients; how to use and understand the “language of pain”.

There will also be discussion of controversial subjects such as whether chronic pain is always neuropathic and whether neuropathic pain is always chronic, or how much mixed pain or localized neuropathic exist. New topics will be added every year as how to assess pain in minimally conscious patients and in cognitive impaired subjects. We are now at our seventh year of this School, supported and implemented by EFIC Presidency, with an innovative, challenging style. Each of us is certainly motivated by best intentions, but the success of the School depends heavily on the capacity of the participants will have to be active protagonists.

This part of the activity means not only learning, but also helping us to develop and improve on-site models and diagnostic pathways.

With my best wishes,

                            

dr. R. Casale