SerdarErdine,HansG.Kress(Eds.)

EFICTHEFIRST20YEARS

1.EDITORIAL“...forwithoutmemoryofthepastthereisnohistory,inthesenseoftheeventsthataremeaningfultothecollective,eventsexperiencedbyacollectivethatisawareofthem.Collectiveconsciousnesspresumescollectivememory,aswithoutitthereisnolawandjustice,nopoliticalstructure,andnocollectiveobjectives.”G.W.F.Hegel(1770-1831):ThePhilosophyofHistoryIn 2013, it has been 20 years that EFIC, the European Federation of IASPChapters,wasfoundedinParisundertheleadershipofProf.UlfLindblom,whoalsoservedEFICasPresidentinthoseearlyyears.HehadavisionofEFIC,andhegaveEFICthemissionofbeing“...acommonreasonormechanismtomeetwith each other and also, to spread knowledge about the progress in painresearchandinpaintreatment.”Consciousnessofyourownhistoryispivotalnotonlytoanindividualbutalsotoaprofessionalscientific,medicalandhealthcarebodylikeEFIC.Itdoesnotjustmeanrememberingthepastasabulkofeventsbutasalivingcontinuity,whichprovidesuswithlessonsfromthepastandguidanceforthefuture.Although still young, EFIC has meanwhile become a mature and flourishingPainFederation.Lookingbackattwodecadesnow,thehistoryoftheremarkablegrowth of EFIC isworth being appropriately celebrated and reported inmoredetailwiththepresent20thanniversarypublicationon“TheFirst20Years”.Overthoseyears,manypeoplehavevolunteeredtheirtimeandenergyandhavecontributedtothedevelopmentandsuccessoftheFederation-writingaboutthehistory of EFIC is a way of paying our tribute to all these people and theirsubstantial commitment, trying to appreciate and understand their aspirations,dreams,andachievements.IntheshorthistoryofEFICweunfortunatelyhavetomourn over the tragic death of the former EFICPresident Prof.DavidNiv inFebruary2007,whohadpavedthewayofEFICwithhispioneeringinitiatives.Twentyyearsalsostandfor:eightEFIC“PaininEurope”Congressesthathavesteadily grown in attendance and importance; EFIC´s scientific journal, theEuropeanJournalofPain,becomingoneoftheleadingjournalsinthefield;theEuropeAgainstPain initiative; theEFICDeclarationonChronicPain,and theEuropeanWeek Against Pain awareness campaign, which has turned into theEuropeanYearAgainstPain(EYAP)– theseandmanymoreachievementsarewhatthisbookonthehistoryofEFICisallabout!

EFIC has become a European trademark in supporting professional educationandpainresearch, forpromotingpainmedicine, fightingfor therecognitionofchronic pain as a disease in its own right, and calling on society for adequatepain relief to be considered a fundamental human right. Now, in 2013, theEuropeanPainFederationEFICproudlycelebratesasuccessfuljourneythathasbegun 20 years ago. This journey has made EFIC the active and strongEuropeanPainFederation it is today– ready for facingnewchallenges in theyearstocome.The editors of this 20th anniversary publication thank all authors,who kindlyhavecontributedchapters.WearealsoverygratefultoKenes,Grünenthal,WIPand many others who willingly provided photos and other – often private –material for this book. In particular, we greatly acknowledge the outstandingeditorialassistanceandsupportfromDr.BirgitKoflerandtheproductionteamofBettschart&KoflerPublishinginVienna.Serdar Erdine, Former EFIC President 2005 – 2008, Hans G. Kress, EFICPresident

2.EFICATAGLANCEThe European Pain Federation (EFIC®), established in 1993, is amultidisciplinary professional organisation in the field of pain research andmedicine, consisting of the 36 European chapters of the InternationalAssociationfortheStudyofPain(IASP),whicharetheIASPapprovedofficialNational Pain Societies in each country. EFIC’s constituent chapters representPainSocietiesfrom36Europeancountriesandcloseto20,000physicians,basicresearchers, nurses, physiotherapists, psychologists and other healthcareprofessionals across Europe, who are involved in pain management and painresearch.

AimsTheaimsofEFICaretoadvanceresearch,education,clinicalmanagementandprofessional practice related to pain, and to serve as an authoritative,scientifically based resource concerning policy issues related to pain and itsmanagement.EFIC creates a forum for European collaboration on pain issues and toencouragecommunicationataEuropeanlevelbetweenIASPchapters,andwithother bodies interested or involved in the fields of pain research and therapysuch as the European societies or federations of medical specialities

(anaesthesiology, neurology, headache, palliative care, etc.), institutions of theEuropeanCommunity,Europeanandnationaleducatorsandlegislators.

ConstitutionTheaffairsofEFICareconductedbyitsCouncil,whichconsistsofthePresidentor theCouncillorofeachEFICchapter,and fiveelectedofficers including theEFICPresidentwhoformtheExecutiveBoard.TheCouncilmeetsonceayearwhile the Executive Board manages affairs between meetings. EFIC isestablishedasanon-governmentalorganisationinBelgium.

EFICOfficeGrensstraat7,Mailbox3B-1831DiegemBelgiumChristelGeevelsExecutiveSecretarySarahDarleyAssistentsecretary@efic.orgTel:+3222515510Fax:+3222514810

3.EFICEXECUTIVEBOARDS1993-20141993-1996President:Prof.UlfLindblomVicePresident:Prof.AndrewDiamondHonorarySecretary:Prof.GiustinoVarrassi

1996-1999President:Prof.ManfredZimmermannVicePresident:Prof.LeonPlaghkiHonorarySecretary:Prof.GiustinoVarrassi

HonoraryTreasurer:Prof.SerdarErdine

1999-2002President:Prof.DavidNivVicePresident:Prof.HaraldBreivikHonorarySecretary:Prof.SerdarErdineHonoraryTreasurer:Prof.GiustinoVarrassi

2002-2005President:Prof.HaraldBreivikPresident-Elect:Prof.SerdarErdineHonorarySecretary:Dr.ChrisWellsHonoraryTreasurer:Prof.JoséCastroLopes

2005-2008President:Prof.SerdarErdinePresident-Elect:Prof.GiustinoVarrassiImmediatePastPresident:Prof.HaraldBreivikHonorarySecretary:Dr.BeverlyCollettHonoraryTreasurer:Prof.HansG.Kress

2008-2011President:Prof.GiustinoVarrassiPresident-Elect:Prof.HansG.KressImmediatePastPresident:Prof.SerdarErdineHonorarySecretary:Prof.PerHanssonHonoraryTreasuser:Prof.EliAlon

2011-2014President:Prof.HansG.KressPresident-Elect:Dr.ChrisWellsImmediatePastPresident:Prof.GiustinoVarrassi

HonorarySecretary:Ass.Prof.NevenkaKrčevskiŠkvarčHonoraryTreasuser:Prof.EliAlon

4.EFICNATIONALCHAPTERSAlbaniaAlbanianPainAssociation(ShoqataShqiptareEDhimbjes)President:Dr.ApostolVasoEFICCouncillor:Dr.ApostolVasowww.healthpain-al.com

AustriaAustrianPainSociety(ÖsterreichischeSchmerzgesellschaft,ÖSG)President:Dr.GabrieleGrögl-AringerEFICCouncillor:Prim.Prof.Dr.RudolfLikarwww.oesg.at

BelgiumBelgianPainSociety(BPS)President:Dr.GuyHansEFICCouncillor:Dr.PatriceForgetwww.belgianpainsociety.org

BosniaandHerzegovinaAssociationforPainTherapyinBosniaandHerzegovina(UdruzenjezaterapijubolauBiH,UTBBiH)President:AmiraKarkinTais,MDEFICCouncillor:AmiraKarkinTais,MDwww.apt-bh.ba

Bulgaria

BulgarianAssociationforStudyandTreatmentofPain(БЪЛГАРСКА АСОЦИАЦИЯ ЗА ИЗСЛЕДВАНЕ И ЛЕЧЕНИЕ НАБОЛКАТА)President:Prof.IvanSmilovEFICCouncillor:Prof.IvanSmilovwww.rtb-mu.com/anestsoc

CroatiaCroatianAssociationfortheTreatmentofPain(Hrvatskodruštvozalijecenjeboli)President:Ass.Prof.Dr.IvanRadosEFICCouncillor:Ass.Prof.Dr.IvanRadoswww.hdlb.org

CzechRepublicCzechPainSociety(Společnostprostudiumaléčbubolesti,SSLB)President:Ass.Prof.JiøíKozákMD.,PhDEFICCouncillor:Prof.RichardRokyta,MD,PhD,DScwww.pain.cz

DenmarkDanishPainSociety(DanskSmerteforum,DSF)President:GitteHandberg,MDEFICCouncillor:Prof.ThomasGraven-Nielsen,PhD,DMScwww.dansksmerteforum.dk

EstoniaEstonianPainSociety(EestiValuSelts)President:BorisGabovits,MDEFICCouncillor:KairePakkonen,MD

www.valu.ee

FinlandFinnishAssociationfortheStudyofPain(SuomenKivuntutkimusyhdistysry)President:VuokkoHägg,MA,MPsychEFICCouncillor:NoraHagelberg,MD,PhDwww.suomenkivuntutkimusyhdistys.fi

FranceFrenchSocietyfortheStudyandTreatmentofPain(SociétéFrancaised’EtudeetdeTraitementdelaDouleur,SFETD)President:Dr.SergePerrot,MD,PhDEFICCouncillor:Dr.GisèlePickeringwww.sfetd-douleur.org

GermanyGermanPainSociety(DeutscheSchmerzgesellschafte.V.)President:Prof.Dr.MichaelSchäferEFICCouncillor:Prof.Dr.MichaelSchäferwww.dgss.org

GreeceHellenicSocietyofAlgology(ΕλληνικήΕταιρίαςΑλγολογίας)President:EmmanouilAnastasiou,MD,PhDEFICCouncillor:EmmanouilAnastassiou,MD,PhDwww.algologia.gr

HungaryHungarianPainSociety

(MagyarországiFájdalomTársaság)President:JanosTajoti,MD,PhDEFICCouncillor:Prof.JanosSzolcsanyiwww.fajdalom-tarsasag.hu

IrelandIrishPainSocietyPresident:Prof.DavidFinnEFICCouncillor:Dr.RaymondVictorywww.irishpainsociety.com

IsraelIsraelPainAssociationPresident:SilviuBrill,MDEFICCouncillor:SilviuBrill,MDwww.ipa.org.il

ItalyItalianAssociationfortheStudyofPain(AssociazioneItalianaperloStudiodelDolore,A.I.S.D.)President:Dr.EnricoPollatiEFICCouncillor:Prof.StefanoCoaccioliwww.aisd.it

KosovoProfessionalHealthAssociation-PainSectionKosovo(AsociacioniShëndetësorProfesional)President:Dr.AdemJ.BytyqiEFICCouncillor:Dr.AdemJ.Bytyqiwww.pha-ks.com

Latvia

LatvianAssociationfortheStudyofPain(LatvijasSāpjuizpētesbiedrība)President:Prof.Dr.InaraLoginaEFICCouncillor:Prof.Dr.InaraLoginawww.sapes.lv

LithuaniaLithuanianPainSociety(LietuvosSkausmoDraugija)President:ArūnasŠčiupokas,MD,PhDEFICCouncillor:ArūnasŠčiupokas,MD,PhD

MoldovaMoldovanPainSociety(SocietateaPentruStudiulsiCombatereaDureriiDinMoldova–SCDM)President:ssProfAdrianBeliiEFICCouncillor:ssProfAdrianBelii

NorwayNorwegianPainForum(NorskSmerteforening)President:Prof.PetterBorchgrevinkEFICCouncillor:Dr.AstridWoodhousewww.norsksmerteforening.no

PolandPolishAssociationfortheStudyofPain(PolskieTowarzystwoBadaniaBólu)President:Prof.JanDobrogowski,MD,PhDEFICCouncillor:Prof.AndrzejBasinskwww.ptbb.pl

PortugalPortugeseAsscoiationfortheStudyofPain(AssociaçãoPortuguesaparaoEstudodaDor,APED)President:Dr.AnaPedroEFICCouncillor:Dr.DuarteCorreiawww.aped-dor.org

RomaniaRomanianAssociationfortheStudyofPain(AsociatiaRomanPentruStudiulDurerii,ARSD)President:Prof.DrMonicaCirstoiuEFICCouncillor:Prof.Dr.AdrianaSarahNicawww.arsd.ro

RussiaRussianAssociationfortheStudyofPain,RASP(Российскоеобществопоизучениюболи,РОИБ)EFICCouncillor:Dr.MaximV.Churyukanov,MD,PhDwww.painrussia.ru

SanMarinoSanMarinoAssociationfortheStudyofPain(AssociazioneSammarineseperloStudiodelDolore)President:VitalbaVitale,MDEFICCouncillor:DanieleBattelli,MDwww.assd-rsm.org

SerbiaSerbianAssociationofPainResearchandTreatment(UdruzenjezaistrazivanjeitretmanbolaSrbije,UITBS)President:Prof.MiroslavaPjevic,MD,PhD

EFICCouncillor:SnezanaTomasevicTodorovic,MDwww.uitbs.org.rs

SlovakiaSlovakSocietyforStudyandTreatmentofPain(Slovenskáspolocnostprestúdiumaliecbubolesti,SSSLB)President:MartaKulichová,MD,PhDEFICCouncillor:MartaKulichová,MD,PhDwww.pain.sk

SloveniaSlovenianAssociationforPainManagement(SlovenskoZdruzenjeZaZdravljenjeBolecin,SZZB)President:Ass.GorazdPozlep,MDEFICCouncillor:BarbaraKosminaStefancic,MDwww.szzb.si

SpainSpanishPainSociety(SociedadEspañolaDelDolor)President:Dr.DiegoContrerasdelaFuenteEFICCouncillor:Dr.JuanPerez-Cajaravillewww.sedolor.es

SwedenSwedishPainSociety(SvensktSmartForum)President:Prof.MalinErnberg,DDS,PhDEFICCouncillor:Prof.MalinErnberg,DDS,PhDwww.svensktsmartforum.se

Switzerland

SwissAssociationfortheStudyofPain(SchweizerischeGesellschaftzumStudiumdesSchmerzes–SociétéSuissepourl’EtudedelaDouleur–AssociazioneSvizzeraperloStudiodelDolore)President:Dr.AndréLjutowEFICCouncillor:Dr.ChristineCedraschi,PhD,PDwww.pain.ch

TheNetherlandsDutchPainSociety(DPS)President:Prof.KrisVissersEFICCouncillor:MichielReneman,MDwww.dutchpainsociety.nl

TurkeyTurkishSocietyofAlgology(TürkAlgolojiDerneği)President:Prof.MeltemUyar,MDEFICCouncillor:Prof.SüleymanOzyalçin,MDwww.algoloji.org.tr

UkraineUkrainianAssociationfortheStudyofPain(Украинскаяассоциацияпоизучениюболи)President:Prof.IgorRomanenko,MD,PhDEFICCouncillor:VolodymyrRomanenko,MDwww.pain.in.ua

UnitedKingdomTheBritishPainSocietyPresident:Dr.WilliamCampbellEFICCouncillor:Dr.AndrewBaranowski

www.britishpainsociety.org

5.MILESTONESINTHEHISTORYOFEFIC1993The European Federation of IASP Chapters (EFIC) was founded during theIASPWorldCongressonPainheldinParisin1993.ThefirstExecutiveBoardof EFIC included Prof. Ulf Lindblom, the founding President, Prof. AndrewDiamond, serving as Vice President, and Honorary Secretary Prof. GiustinoVarrassi.

Prof.SerdarErdineandProf.UlfLindblom,foundingPresidentofEFIC

1995The initiative of producing an official EFIC journal, the European Journal ofPain, took shape, and Prof. Ulf Lindblom became the Editor-in-Chief. AnEditorialBoardwasformed.ThefirstEFICCongress,PaininEuropeI,washeldinVerona,Italy,from18to21May.TheChairoftheLocalOrganisingCommitteewasProf.StefanoIschia.Morethan1,000participantsattendedtheevent.

ThefirstExecutiveBoardofEFIC.Fromlefttoright:Prof.AndrewDiamond,Prof.UlfLindblomandProf.GiustinoVarrassi

During theEFICCongress inVerona, theEFICCouncilmet for the first time.TheNationalPainSocieties from Israel andTurkeywere accepted as nationalchapters. The position ofHonoraryTreasurerwithin theExecutiveBoardwasalsoestablishedatthefirstCouncilMeeting.Dr.RicardoRuizLopez and theSpanish IASP chapter offered to organise thesecondEFICCongressinBarcelona.TheEFICCouncilacceptedthisoffer.Dr.Douglas Justins served as Chairman of the Scientific Committee for theBarcelonaCongress.

Prof.StefanoIschia,ChairoftheEFICCongressPaininEuropeIinVerona

1996ThesecondExecutiveBoardofEFICwaselectedinMarchbytheEFICCouncilinBrussels. Itwas composed of Prof.Manfred Zimmermann, President, Prof.Leon Plaghi, Vice President, Prof. Giustino Varrassi, Honorary Secretary andProf.SerdarErdine,HonoraryTreasurer.

EFICCouncilMeeting,Brussels,March1996

During theEFICCongress inVerona, theEFICCouncilmet for the first time.TheNationalPainSocieties from Israel andTurkeywere accepted as nationalchapters. The position ofHonoraryTreasurerwithin theExecutiveBoardwasalsoestablishedatthefirstCouncilMeeting.Dr.RicardoRuizLopez and theSpanish IASP chapter offered to organise thesecondEFICCongressinBarcelona.TheEFICCouncilacceptedthisoffer.Dr.Douglas Justins served as Chairman of the Scientific Committee for theBarcelonaCongress.

EFICExecutiveBoard1996–1999.Fromlefttoright:Prof.SerdarErdine,Prof.DavidNiv,Prof.ManfredZimmermann,Prof.GiustinoVarrassiandProf.LeonPlaghi

1997In the spring of 1997, the first issue of the European Journal of Pain waspublished, containing a number of editorials, a review paper and five originalresearchpapers.ThesecondEFICCongress,PaininEuropeII,washeldinBarcelonafrom23to27 September. About 1,500 participants from all over the world attended theevent.EFICreceivedanattractiveshareoftheincomeoftheCongress,thefirstincomeEFIChadeverearned.AttheBarcelonaCouncilMeeting,theFrenchIASPchapterofferedtoorganisethe third EFICCongress inNice in 2000 and the EFICCouncil agreed. Prof.Harald Breivik became Chair of the Scientific ProgrammeCommittee for theNiceCongress.TheEFICCouncilapprovedpursuingthelegalregistrationoftheFederationinBelgiumandendorsedthedraftbylaws.

1999Electionsfor the third termof theEFICExecutiveBoardwereheldduring themeeting“PaininaMediterraneanCorner”,organisedbytheIsraeliPainSociety,the Turkish and Greek IASP chapters in Heraklion, Greece, in March. Prof.David Niv was elected President, Prof. Harald Breivik Vice President, Prof.Serdar Erdine Honorary Secretary and Prof. Giustino Varrassi HonoraryTreasurer. Prof. Leon Plaghi from Belgium was ex-officio member of theExecutiveBoardaccordingtothebylawsatthattime.EFIC was officially registered in Belgium. Regular accounts were set up forEFICinBrussels.TheExecutiveBoarddecidedtoestablishanEFICSecretariatindependentoftheSecretariat of the Belgian IASP chapter. The office was moved to a separatelocation.ABylawsCommitteewasestablishedinAugust.TheEuropeanJournalofPainproducedafinanciallypositivebalanceinitsthirdyearofpublication,generatingamodestprofitforEFIC.

EFICExecutiveBoard1999–2002.Fromlefttoright:Prof.GiustinoVarrassi,Prof.HaraldBreivik,Prof.DavidNivandProf.SerdarErdine

2000The thirdEFICCongress, Pain inEurope III,was held inNice inSeptember;morethan2,000participantsattendedtheevent.Prof. Ulf Lindblom, first Editor-in-Chief of the European Journal of Pain,informed the CouncilMeeting in Nice about his decision to resign from thisposition.Prof.FernandoCerverowasappointedhissuccessorandProf.HaraldBreivikDeputyEditor.At thesamemeeting,an importantEFICinitiativewasestablishedfollowingaproposalbythethenPresidentProf.DavidNiv:EuropeAgainstPain(EAP).It was also agreed that Sir Michael Bond would attend Executive BoardMeetingsinhiscapacityasIASPLiaison.Prague was chosen by the EFIC Council as the venue for the fourth EFICCongress in 2003. Prof.DanielLeBarswas appointedChair of theScientificProgrammeCommitteeforthePragueCongress.

AhistoricdecisionwastakenbytheEFICExecutiveBoardfollowingaproposalbythethenPresidentProf.DavidNiv.Inthefuture,profitsresultingfromEFICCongresses would be distributed between EFIC and the respective nationalchapteratarateof90%to10%infavourofEFIC.Previously,theratehadbeenjusttheopposite.TheEuropeAgainstPaininitiativeledtoanotherlandmarkin2000,namelythedecision toestablishaEuropeanWeekAgainstPain (EWAP).The intentionoftheEWAPwastocreatemoreawarenessofpainasamajorhealthcareproblem.

LaunchoftheEFICDeclarationattheEuropeanParliament.Fromlefttoright:Prof.HaraldBreivik,Prof.B.Seesle,SirMichaelBond,Prof.DavidNiv,Prof.SerdarErdine,andProf.UlfLindblom

2001In March, at a meeting in Athens, agreement was reached on the EFIC“Declaration on Pain as a Major Healthcare Problem, a Disease in its OwnRight.”Thisimportantdocumentwaslaunchedlaterthatyear,inOctober,attheEuropean Parliament in Brussels. The declaration was translated into thenationallanguagesofallEFICchapters.InMarch, theconceptof“EFICInnerCircleMembership” forcompanieswasestablishedwhichwastoprovidesignificantexposureandnetworkingpotentialforindustrypartnersofEFIC.In June, the EFICCouncil,meeting in Lugano, Switzerland, adopted the newEFICbylaws.ThemostimportantchangeconcernedtheExecutiveBoard,whichwas now composed of five members: the President, the President-Elect, theImmediatePastPresident,theHonorarySecretaryandtheHonoraryTreasurer.InAugust,“Don’tSufferinSilence”wasacceptedastheleadingsloganfortheEuropeAgainstPaininitiative.FollowingthelaunchoftheEFICDeclaration,thefirstEuropeanWeekAgainstPain was organised from 12 to 14 October. EFIC chapters arranged localawarenesscampaigns.

SignaturesontheEFICDeclaration

2002At itsmeeting inBrussels inApril, theEFICCouncilelectedanewExecutiveBoard for the term 2002 to 2005. It consisted of Prof. Harald Breivik asPresident and Prof. Serdar Erdine as President-Elect, Dr. Chris Wells asHonorarySecretary,andProf.JoséCastroLopezasHonoraryTreasurer.InJuly,atameetinginBrussels,thepositionofanExecutiveOfficerwassetup.At the same occasion, EFICHonoraryMembershipwas established and Prof.UlfLindblom,EFIC’s foundingPresident,became the firstHonoraryMember.Lateron,HonoraryMembershipwasgenerallyawardedtoEFICPastPresidents.At itsmeeting inSanDiego inAugust, theEFICCouncil took thedecision tocontract theKenesGroupas theprofessionalcongressorganiser (PCO)for thenextEFICCongresses.

2003InMay,theEFICExecutiveBoard,meetinginIstanbul,approvedtheconceptoforganisinga“GlobalDayAgainstPain”incollaborationwithIASPandWHO.

ThefourthEFICCongress,PaininEuropeIV,washeldfrom2to6SeptemberinPraguewithmorethan3,000delegatesfrom73countries.

TheEFICCouncil,meetingduring thePragueCongress, chose Istanbulas thevenueforthefifthEFICCongressin2006.Prof.MarshallDevorwasappointedChairoftheScientificProgrammeCommitteefortheIstanbulCon-gress.AnewpublishingcontractfortheEuropeanJournalofPainwasnegotiatedwithElsevier, under the guidance of the then Chair of the EFIC PublicationsCommittee,Dr.BeverlyCollett.

PaininEuropeIVCongress:Fromlefttoright:Prof.SerdarErdine,Prof.DavidNiv,Prof.UlfLindblomandProf.RicardoRuizLopez

2004On9October,theGlobalDayAgainstPainwaslaunchedatWHOinGenevaasacommonprojectofEFICand IASP.A“Call forAction”wasadoptedwhichfocussedonthereliefofpainasahumanright.

2005InFebruary,Prof.FernandoCerverohandedoverthepositionofEditor-in-ChiefoftheEuropeanJournalofPaintoProf.HermannHandwerker.At its May meeting in Sofia, Bulgaria, the EFIC Council elected a newExecutive Board for EFIC for the term 2005 to 2008: Prof. Serdar ErdinebecamePresident,Prof.GiustinoVarrassiPresident-Elect,Prof.HaraldBreivikserved as Past President,Dr. BeverlyCollett asHonorary Secretary and Prof.HansG.KressasHonoraryTreasurer.

PressConferenceinGenevatolaunchtheGlobalDayAgainstPain.Fromlefttoright:Prof.SerdarErdine,Prof. D. Johannson, Prof. Michael Cousins, Prof. Troels Staehelin Jensen, Prof. Paul Pionchon, Prof.MichaelZenz,Prof.GiustinoVarrassi,Prof.DavidNiv

InAugust,theEFICCouncilmetinSydneyduringtheIASPWorldCongressonPain.AproposaltoincludetheEuropeanPainSchoolinSienaintheeducationalprogrammeofEFICwasapproved.InDecember,theExecutiveBoarddecidedtomovetheEFICExecutiveOfficeto Greece. At the samemeeting, it was agreed to proceed with setting up adatabasecoveringallindividualmembersofIASPchaptersinEurope.

EFIC Executive Board 2005 – 2008. From left to right: Sir Michael Bond, Dr. Beverly Collett, Prof.GiustinoVarrassi,Prof.SerdarErdine,Prof.HansG.Kress,Prof.HaraldBreivik,andExecutiveSecretarySarahWheeler

2006InApril, itwasdecidedtograntafreesubscriptionoftheEuropeanJournalofPaintomembersoftheEFICchaptersforthreeyears.ASummerSchooloftheEFICEuropeanPainSchoolwasheldinSiena.Avideoon the development ofEFICwas prepared, involving interviewswiththefoundingPresidentProf.UlfLinblomaswellashissuccessors.From13to16September,thefifthEFICCongress,PaininEuropeV,tookplaceinIstanbul,attractingmorethan3,000participantsfromallovertheworld.MeetingduringtheIstanbulCongress,theEFICCouncildecidedtoprovidefreeonlineaccesstotheEuropeanJournalofPaintoallmembersofEFICchapters.

At the same meeting, the EFIC Council approved holding the sixth EFICCongress inLisbon.Prof.MichaelZenzwas appointedChair of theScientificProgrammeCommitteefortheLisbonCongress.InNovember, the ExecutiveBoard decided by amajority vote to relocate theExecutiveSecretariatfromAthenstoBrussels.

EFICCouncilMeetingduringthefifthEFICCongressinIstanbul

2007

InFebruary,EFICmournedthetragicanduntimelydeathofitsformerPresidentProf.DavidNiv.In March, the new EFIC Executive Office in Brussels was opened by theExecutive Board. A new Executive Secretary was appointed and took up herwork. At a May meeting in Assisi, Italy, the EFIC Council approved theterminationofthecontractwiththepreviousExecutiveSecretary.

InmemoriamProf.DavidNiv,EFICPresident1999to2002(*1950†2007)

Changes in the EFIC bylaws were also passed by the Council at the Assisimeeting. Inresponse toadecisionofIASPtoswitchfromtriennial tobiennialcongresses, the Council agreed to also change the intervals between EFICCongressestotwoyears.ThiswouldbecomeeffectiveforthefirsttimewiththeEFICCongressin2011.

EFIC Council Meeting in Assisi. From left to right: Dr. Beverly Collett, Prof. Giustino Varrassi, Prof.SerdarErdineandProf.HansG.Kress

2008DuringtheEFICCouncilMeetinginMay,anewExecutiveBoardwaselectedforthetermlastingfrom2008to2011.ItcomprisedProf.GiustinoVarrassi(President),Prof.HansG.Kress(President-Elect),Prof.SerdarErdine (Past President), Prof. Per Hanson (Honorary Secretary) and Prof. EliAlon (Honorary Treasurer). The new Executive Board officially took over inJune2008.MeetinginViennainMay2008,theEFICCouncildecidedtoholdtheseventhEFICCongress in2011 inHamburgandvotedforFlorenceas the locationfortheeighthEFICCongress2013.

EFICExecutiveBoard2008–2011.Fromleft toright:Prof.EliAlon,Prof.HansG.Kress,Prof.SerdarErdine,Prof.GiustinoVarrassi,Prof.PerHanson;sitting in front:AnnNys (Accountant),CarineJaquet(ExecutiveSecretary)

AtitsViennameeting,theEFICCouncilalsoagreedtotakeactiontosupporttheoverdueimplementationofseparatecodesforchronicpainintothenewICD11,whichwasinpreparationbyWHOatthattime.

Fromlefttoright:Prof.SerdarErdine,PastPresident,Prof.GiustinoVarrassi,President,andProf.HansG.Kress, President-Elect, after theCouncilMeeting inVienna, relaxing on a park bench at the famous“Ringstrasse”

2009ThesixthEFICCongress,PaininEuropeVI,washeldinLisbon,Portugal,from9to12September,bringingtogethermorethan3,000participantsfromallovertheworld.DuringtheLisbonCongress,theEFICCouncilunanimouslyagreedonanewlydesignedEFIClogo.

EFICCouncillorsmeetingattheLisbonCongress

TheEuropeanJournalofPain(EJP)sawasteadyincreaseinsubmissions,fromabout300in2005toaround600in2009.Its impactfactorcameveryclose tothe“magicline“of4.0.After the successful implementation of the EFIC Pain School Klagenfurt,Austria, in 2007, the EFIC Pain School Montescano, Italy, was launched inOctober.In November, the first two courses of the new IntraThecal EFICMasterclass(ITEM)weresuccessfullyruninPaviaandVienna.

2010TheIntraThecalEFICMasterclass(ITEM)programmewascontinued,involvingcentresinVienna,Austria,Lübeck,Germany,Pavia,Italy,andValencia,Spain.InMay, the first Societal Impact of Pain (SIP) Symposium was organised incollaborationwithGrünenthalGmbH inBrussels, and broughtmore than 200health experts and representativesofEuropeanhealth authorities togetherwithbudgetholders,strategicdecision-makers,andotherstakeholders.

SIP2010SymposiuminBrussels

2011InMay,thesecondSIPSymposiumwasheldinBrussels.TheaimsofSIP2011were endorsed by more than 85 international organisations, institutions, andpatientadvocacygroups.ARoadMapforActionlaunchedbyEFICchallengedEuropean governments and EU institutions to acknowledge chronic pain as adiseaseinitsownright,andtomakeitatoppriorityontheirsocialandhealthagenda.After the official dissolution of theScandinavianAssociation for theStudy ofPain,theNationalPainSocietiesfromDenmark,Finland,NorwayandSwedenwere approved as separate members by the EFIC Council at its meeting inBrusselsduring the secondSIPSymposium.TheCouncil alsoelected thenewExecutive Board for the term 2011 to 2014. Apart from Prof. Hans G. Kressserving as President for this term, it includes Prof. Giustino Varrassi (PastPresident), Dr. Chris Wells (President-Elect), Prof. Eli Alon (HonoraryTreasurer),andAss.Prof.NevenkaKrčevskiŠkvarč(HonorarySecretary).The new Executive Board´s term started off in June 2011 at its first officialmeetingattheEFICHeadquartersOfficeinBrussels.Based on a totally remodelled agreement, the Executive Board decided tocontinue the successful collaboration with the professional congress organiserKenesforthenexttwoEFICCongressesin2011and2013.

2011EFICCouncilmeetinginBrussels,includingthenewExecutiveBoardmembers

The publishing contract for the European Journal of Pain with Elsevier was

terminated,and–afterextensivenegotiationsundertheguidanceofProf.HansG.Kress–anewagreementwasconcludedwithWileyBlackwellandsignedinAugust.Duringthecriticaltransitionperiod,theEditor-in-Chief,Prof.HermannHandwerker,andtheEditorialOfficekepteverythingundercontrolandupdatedthelayoutandeditorialconceptofthejournalforfuturechallengesinscientificpublishing.Prof.HansG.KresswaselectedDeputyEditorofthejournal.

EFIC Executive Board 2011 – 2014. From left to right: Prof. Giustino Varrassi, Dr. ChrisWells, Prof.NevankaKrčevskiŠkvarč,Prof.HansG.Kress,Prof.EliAlonwithExecutiveSecretaryChristelGeevels

TheseventhEFICCongress,PaininEuropeVII,washeldinHamburgfrom21to 24 September. The event attracted more than 4,000 participants from 75countries,makingitineveryrespectthemostsuccessfulEFICCongressever.

Prof. Hans G. Kress handing over a commemorative plaque of Honorary Membership to the outgoingPresidentProf.GiustinoVarrassi

DuringtheHamburgCongress,aface-to-facemeetingofthePresidentsofIASPandEFIC,Prof.EijaKalsoandProf.HansG.Kress,openedthewayforafuturecooperationonsharingthetopicsandeducationalmaterialsoftheIASPGlobalYearAgainstPainandtheEFICEuropeanWeekAgainstPain(EWAP).

RepresentativesofEFICandWileyBlackwellafterthesignatureofthepublishingagreementinLondon´sfamousGrouchoClub,amembers-onlypublishersclubinLondon

At its extraordinarymeeting during theHamburgCongress, theEFICCouncilvotedforViennaasthevenueforthe2015EFICCongress.

2012DuringthesixthCongressoftheWorldInstituteofPain(WIP)heldinFebruaryinMiamiBeach,Florida,thePresidentsofEFIC,WIP,theWIPFoundationandtheWorldSocietyofPainClinicians(WSPC)signedthe“DeclarationofMiami”tojoinforcestoachievebetterpaintreatmentandtopromotepainmedicineallover the world. On that occasion, the Presidents also agreed on a closercooperationoftheirprofessionalorganisationsonagloballevel.TheKosovoPainAssociation/ProfessionalHealthAssociationwasacceptedasthe36thEFICmemberattheannualEFICCouncilMeetinginCopenhagen.More than 350 participants gathered for the third SIP Symposium, held inCopenhagen from 29 to 31May. Endorsed bymore than 160 institutions andorganisations, it was another important step towards the public recognition ofchronicpainasaserioussocietalburdenandadiseaseinitsownright.

Presidents holding their handsafter public signatureof the“DeclarationofMiami”.From left to right:Prof. Serdar Erdine, CEOWIPFoundation, Prof. Robert van Seventer, PresidentWSPC, Prof.HansG.Kress, President EFIC, Prof. P. Prithvi Raj, Chairman WIP Foundation, Prof. Ricardo Ruiz-Lopez,PresidentWIP

EFICandIASPjoinedforcesand,forthefirsttime,agreedonacommontopic–“VisceralPain”– tobehighlightedduring the IASPGlobalYearAgainstPainandthenewlylaunchedEFICEuropeanYearAgainstPain(EYAP).Theformerone-weekawarenesscampaignorganisedbyEFICeveryOctober,theEuropeanWeekAgainstPain (EWAP),was thusextended toa fullyear.The firstEYAPand the brand-new EYAP logo were launched on 12 October with aninternationalEFICpressconferenceinBrussels.TheEFICwebsiteunderwentathoroughfaceliftandrestructuring,andtheEFICNewsletterwasre-launchedwithfourregularissuesperyear.TwonewEFICTaskForceswereestablished:“ImplementationofChronicPainintoICD11”and“DrugReimbursementPoliciesinEuropeanCountries”.Duringsummer2012,Prof.HansG.Kress,togetherwiththeChairsoftheEFICTask Force on ICD11, Prof.Winfried Rief and Prof. Rolf-Detlef Treede, metwithWHOrepresentativesinGenevaforpreliminarytalks.ItbecameclearthatWHOwould only accept a global and officiallyWHO-accredited organisationlikeIASPforthecooperationonICD11issues.

AtabilateralmeetingofthePresidentsandotherofficialrepresentativesofIASPand EFIC during the 14th World Congress on Pain in Milan, the twoorganisations agreed to install a common task force for the implementation ofchronicpainintothenewICD11,undertheleadofProf.Treede.

EFICPresidentProf.HansG.Kress,EFICPresident-ElectDr.ChrisWellsandpainpatientJaquelineRileypresentingtheEuropeanWeekAgainstPainandthenewEYAPlogoinBrussels

InNovember,theEFICExecutiveOfficemovedfromVilvoordenearBrusselstoanewlocationatDiegem,closertotheBrusselsAirport.IncooperationwithMundipharmaInt.,EFICinstalleda“EuropeanExpertTaskForceonPlacingPainonUndergraduateMedicalCurricula”inordertoanalysethe current status on the deficits of undergraduate pain education inEuropeancountries, and to develop strategies and recommendations for futureimprovements.ThefirstmeetingwasheldinNovember.

EFICCouncillorsmeetingattheSIP2012SymposiuminCopenhagen

2013The contract relating to the EFIC Congresses 2011 and 2013 with the PCOKenes was renewed for the EFIC Congresses 2015 and 2017, and signed inMarch.On14and15May, theSIP2013Symposiumwasheldagain in theEuropeanParliament inBrussels, this time composed of two FocusGroups for in-depthdiscussions. Focus Group 1 developed quality indicators to measure theconsequencesandoutcomeof improvements inpainmanagementata regionalornationallevel,whereasFocusGroup2discussedbest-practiceexamplesfromdifferentcountries,andworkedonproposalsforactionstopreventchronicityofpainandtobringpainpatientsbacktowork.AsaresultoftheSIP2013SymposiumandinordertocontinueandexpandtheworkofSIPFocusGroup1,an“EFICTaskForceonQualityIndicators”wasinstalledundertheleadofProf.PedroSaturnoandProf.Rolf-DetlefTreede.Based on the curriculum of the German EFIC Chapter (DeutscheSchmerzgesellschaft,formerDGSS),theEFICCommitteeonEducation,chairedby Prof. Andreas Kopf, completed the first “EFIC Pain Management CoreCurriculumforMedicalSchools inEurope”,whichwas launchedat theeighthEFICCongressinFlorence.The eighth EFIC Congress, Pain in Europe VIII, from 9 to 12 October in

Florence, Italy, celebrated the 20th anniversary of EFIC under themotto: “20Years of Building Bridges.” The all-time high of 1,242 abstract submissionscouldbetakenasagoodomenforarecord-breakingattendanceinFlorence.TheEuropeanYearAgainstPain2013to2014on“OrofacialPain”waslaunchedatanEFICpressconferenceduringtheFlorenceCongress.The first results of the “European Expert Task Force on Placing Pain onUndergraduate Medical Curricula” were presented during the Pain in EuropeVIIICongress,providinga robust analysisof thecurrent statuson teachingofpainmedicineacrossEuropeanMedicalSchools.TheFederation’snamewaschangedto:TheEuropeanPainFederationEFIC®.

6.EFICPRESIDENTS1993–2014“Itoccurredtomeitwouldbeagoodthing...”

Prof.UlfLindblom,MD,DMSc,EFICPresident1993–1996

EFIC owes its existence to the vision and determination of the pioneeringSwedish neurologist Prof.UlfLindblom.As early as 1976 he had formed the

Scandinavian Association for the Study of Pain, the first regional chapter ofIASP. Its success was no doubt a source of inspiration when, in 1993, asPresident of the International Association for the Study of Pain (IASP), Prof.Lindblomproposed,duringtheWorldCongressonPaininParis,aFederationofIASP chapters inEurope to improve cooperation and communication not onlywithIASPbutbetweentheEuropeanPainSocieties.“ItoccurredtomethatEFICwouldbeagoodthing,”heremembered.Ashesawit,suchanetworkwouldbeinabetterpositiontoofferadviceforpaintreatmentspecificallytailoredtotheneedsofEuropeanhealthsystemsandpatients.“IamextremelyhappythatEFIChasdevelopedinthisway.”“Wehadtofindaneasywaytocommunicatewiththerestofthepainworld,”hesaid.“Oneof themajorchallengeswithexpandingEFICwas thedifference ineducation and in development and healthcare specialisations in the differentEuropean countries. TheEast European countries had lagged behind, but theyhave advanced quickly. This proves, I think, that EFIC can make a largecontribution.”Prof.LindblomalsofoundedandbecamethefirstEditor-in-ChiefoftheofficialEFIC journal, the European Journal of Pain, whose first edition appeared in1997. Within a matter of years, the journal rapidly developed into a highlysuccessfulscientificjournal,withanimpressiveimpactfactor.With a dual background in neurophysiology and clinical neurology, Prof.Lindblom was instrumental in establishing the principle that sensoryabnormalitiesassociatedwithpainmeritedspecificattention.Hebecameknownthroughouttheworldforhisground-breakingresearchintoquantitativesensorytesting (QST). This work provided a basis for classifying different types ofneuropathies, notably those based on hyperalgesia and allodynia. Prof.Lindblom’stechniqueshavebeenappliedthroughouttheworldtoproducebetterdiagnosesandimprovedevaluationofpotentialtherapies.Hehasbothinitiatedandguidedalargenumberofkeyclinicalstudies.Prof. Lindblom is Professor Emeritus of Neurology at Sweden’s KarolinskaInstitutet,wherehewasformerlyChairmanoftheDepartmentofNeurology.

“SpreadingthewordinEuropeaboutbettertreatmentforpain.”

Prof.Dr.-Ing.Dr.med.etchir.h.c.ManfredZimmermann,EFICPresident1996–1999

EFIC’ssecondPresident, theGermanphysicistandphysiologistProf.ManfredZimmermann,wasalsooneofitsfounders,ashewasofIASPin1973.HeunderlinesthevalueofcooperatingwiththeEuropeaninstitutions.“OneofthemostimportanteventsduringmypresidencywasourofficialrecognitionbytheEuropeanParliament in 1998,” he says.TheEuropeanWeekAgainst Paincampaignshadproducedexcellentresults.“Theygivenewhopeparticularlytochronicpainsufferers thatdoctorsmaybebetterable tohelpthem.”EFIChadbecome known not only among health professionals and health policymakersbutthegeneralpublic.Prof.ZimmermannstudiedphysicsandphysiologyatKarlsruheandHeidelbergUniversities, becoming Head of the Department of CNS Physiology atHeidelberg in 1971, and Professor of Physiology two years later. His mainresearch interesthasbeen inneuronalmechanismsofpainandpain inhibition,with a focus on neuropathic pain. Later he became interested in genetranscriptioncontrolandapoptosisinthenervoussystem.In1975heco-foundedtheGerman-speakingPainSocietycoveringGermany,Austria,andSwitzerland,whichhepresidedoverfrom1984to1993.AfterthisGerman-speakingregionalIASP chapter was divided into three separate National Pain Societies, hecontinuedtobethePresidentofthenewlycreatedGermanIASPchapterDGSSfrom1993to1996.AtIASP,hechairedtheCommitteeforEthicalIssuesinPainResearch, from1978 to 1990, developing, inter alia, guidelines for the ethicaltreatmentoflaboratoryanimals.In1996hesuccessfullyestablishedpaintherapyasamedicalsubspecialityinGermany.

Throughout his career Prof. Zimmermann has been intensively involved inpublishing.Hehimself is responsible for800publications.From1975 to2003hewasfounderandEditor-in-ChiefofNeuroscienceLetters,andfrom1987to1992 foundingeditorofDerSchmerz. In1984hewaseditorandco-authorofthefirstGermantextbookonpain(Schmerz-KonzepteundärztlichesHandeln),and in 1986 co-wrote an official report on the national status of pain researchandtherapyfortheGermangovernment.Hehassatonanumberofeditorialboards,includinguntil1987thatofIASP’sprestigious internationalpublicationPain, and servedas avisitingprofessor inMelbourne,Australia,Wuhan,China,andattheUniversityofSiena,Italy.

“One in five Europeans is in pain. They have afundamentalrighttotreatment.”

Prof.DavidNiv,MD,FIPP†,EFICPresident1999–2002

The tragicdeathat57ofEFIC’s thirdPresident, the indefatigableProf.DavidNiv,wasa terribleloss tothepaincommunityandtothemanywhoknewthisbrilliant,humorous,andunusualman.Bulgarian-born, Prof. Niv was one of the world’s leading experts on paintherapy.ServingasaCouncilMemberofIASP,hewasPresidentof theWorldInstituteofPain from2002 to2005andco-founderandPresidentof the IsraelPainAssociationfrom1988to1992.AtthetimeofhisdeathhewasDirectoroftheMultidisciplinaryPainControlUnitandPainResearchLaboratory,TelAvivSourasky Medical Center, and Professor of Anaesthesia and Critical CareMedicineatTelAvivUniversity.Amonghisimportantcontributionswastopromotetheideaofpainasadisease

initsownright,andofthenecessitytodevelopEuropeancorecurriculainpainmedicine formedical schools aswell as for specialisation and certification inpain medicine. EFIC should use its strength to get this implementedinternationally, he argued: “Pain is now recognised in several of theEuropeancountriesasamedicalspecialityinitsownright.”Inhisviewafundamentalchangeofattitudetowardschronicpainwasneeded.“Weneedtostopthinkingofpainasasymptom,andstartseeingitasadiseaseinitsownright.Cancerisadisease;soispain,chronicpain,atleast.AndoneinfiveEuropeans is inpain, ranging frommediumtovery intense. It isahumanright to obtain treatment, and for that treatment to be appropriate andcontinuous.”HewasproudofthesloganfortheEuropeanWeekAgainstPainlaunchedattheEuropeanParliamentin2001duringhisPresidencyofEFIC–“Donotsufferinsilence”–andsawthecampaignasawatershed inspreading themessage thatchronic pain is a disease. The cost of treating chronic pain rivalled, evensurpassed that for treating all cancers and cardiovascular disease, but stillattractednegligible funding for research,hewouldargue.Oneofhis favouritephraseswas:“Fewdieofpain,butmanydieinpain,evenmoreliveinpain.“Sonof adoctorwhoemigrated to Israel,Prof.Nivgraduated in1977with anMD from the University of Bologna in Italy and trained in anaesthesia andintensivecareinTelAviv.HethenwentontoworkwithProf.MarkChayen,ananaesthesiologist who in the mid-1960s had established one of Israel’s firstmulti-disciplinarypainclinicsatTelAvivUniversity’sSouraskyMedicalCenter.DavidNivsucceededhimasitsdirectorwhenheretiredin1988.Prof. Niv took a particular interest in invasive procedures such as precision-guidednerveblocksandablations,and later theuseof implantablepumpsandspinal cord stimulators. He also undertook research into DNA markers offamilialdisease.Inallhehadmorethan120publishedscientificarticlestohisname. In the final months of his life, Prof. Niv was working on a documentaimedatraisingtheprofileofpainresearchinEurope.

“EFIC: An important leap forward in the science ofpain.”

Prof.HaraldBreivik,MD,DMedSc,FRCA,EFICPresident2002–2005

HaraldBreivik,ProfessorofAnaesthesiologyatRikshospitalet,OsloUniversityHospital,Oslo,andfoundingPresidentoftheNorwegianPainSociety,usedhisthreeyearsasPresidentofEFICtobuildonitsrapidly-growingprestige.Oneofthe highlights during this period was the 2004 Global Day Against Pain, co-sponsored by EFIC, WHO and IASP; it attracted worldwide attention. Thecampaignfocusedon“thetreatmentofpain,abasichumanright.”The EFIC Congress held in Prague the year before, in September 2003, hadgreatly enhanced EFIC’s standing. “We had 700 abstracts, and almost 200invitedspeakers.AndforthefirsttimetheCongresssecuredsubstantialincomeforourFederation,“ saysProfBreivik. “In another important achievement,wewereabletoestablisharesearchgrantforyoungclinicalresearchers–theEFICGrünenthalGrant,worth€100,000ayear.”TheEuropeanJournalofPainalsooccupiedmuchofhisattention;he tookonthe job of Deputy Editor from 2000 to 2008. The journal has progressivelyestablished itself as EFIC’s scientific flagship, attracting more and moredistinguishedcontributionsandagrowingnumberofsubscribers.“EFICcertainlyhasmade a very important improvement in theunderstandingandmanagement of acute pain, chronic pain, and cancer pain in Europe,” hesummarises.Authorofover350papersandbookchaptersonanaesthesiology,intensivecare,emergencymedicine,painrelief,physiology,andpathophysiology,Prof.Breivik

hasalsoeditedanumberofkeytextbookssuchasClinicalPainManagement–Practical Applications and Procedures, (Hodder-Arnold, 1st Ed 2003, 2nd Ed2008),andPain:BestPracticeandResearchCompendium(Elsevier2007).As co-founder and HonoraryMember of IASP, Prof. Breivik has been a keyfigure in pain treatment for some four decades since completing hisMD andDMedSc studies at Oslo University, and a fellowship in anaesthesiology,intensivecare,andpainmedicineattheUniversityofPittsburgh.Heisfoundingmember and Past President of the Scandinavian Association for the Study ofPain (SASP)and since2009 the foundingEditor-in-ChiefofSASP’s scientificjournal, the Scandinavian Journal of Pain. An Executive Board Member andVice-President of the World Federation of Societies of Anaesthesiologists(WFSA), he was elected Fellow of the Royal College of Anaesthetists (UK),HonoraryFellowoftheCollegeofAnaesthetistsofIrelandandHonoraryFellowoftheFacultyofPainMedicineoftheCollegeofAnaesthetistsofIreland.HeisHonoraryMemberoftheGermanSocietyofAnaesthesiologyandIntensiveCareMedicine, HonoraryMember of the Norwegian Society of Anaesthesiologistsand Honorary Member of the Slovak Pain Society and of the British PainSociety.He is aKnight of the 1stClass of theRoyalNorwegianOrder of St.Olav.

“I had the great opportunity towitness howEFICgrewandbecameawell-respectedinternationalpainsociety.”

Prof.SerdarErdine,MD,FIPP,EFICPresident2005–2008

“Duringthe15yearsIservedontheExecutiveBoardofEFIC,Ihadthegreat

opportunity to witness how EFIC grew and became a well-respectedinternationalpainsociety,”Prof.SerdarErdinesays.“Besidesbeingafederationof European chapters of IASP, EFIC has proven itself to be an internationalorganisation that has had a great impact on promoting pain medicine byorganising Congresses, Pain Schools, the European Weeks and now YearsAgainstPain,andotheractivitiesaswellasbypublishingtheEuropeanJournalofPain.EFIChascreatedafriendlyatmospherewherenationalchaptersaswellasotherscansharetheiraspirationsforbetterpaintreatmentandpainreliefasahumanright.”The EFIC presidency under Serdar Erdine, Professor of Anaesthesiology andAlgologyatIstanbulUniversity,wasmarkedbyadeterminedpushtoexpandtheorganisation, especially into Eastern Europe, and to enhance communicationamong all national chapters, inter alia through a website which specificallyfocussedoneducation.Prof.ErdineisproudofhiscontributiontomakingEFIC“averystrongpoliticalpower in Europe,” a reminder that as a youngman he had initially hoped tostudypoliticalscienceratherthanmedicine.Heremainsgratefulthatfatepushedhiminthedirectionitdid.Achievingaprofessorshipinhisthirties“wasperhapsthebiggestchanceofmylife,”hesays.Prof.ErdinegraduatedfromCerrahpasaMedicalFaculty,IstanbulUniversity,in1978 and completed his residency in the Department of Anaesthesiology andReanimation in 1982. He was named Associate Professor in Anaesthesiologyfour years later and was promoted to Professor of Anaesthesiology andAlgology in 1991. After becoming especially interested in pain managementwhiledoinghismilitaryservice inCyprus,hesubsequentlypioneeredepiduraltreatments in Turkey. He became a member of IASP in 1981 as pain studiesbegan togainmomentum, and then founder andPresidentof theTurkishPainSocietyandoftheTurkishSocietyofRegionalAnaesthesia.Healsoco-foundedtheWorldInstituteofPain(WIP)in1994,becomingitsPresidentfrom2008to2011.HeremainsCEOoftheWIPFoundation,andhasservedasamemberoftheWHOAdvisoryExpertPanelonDrugDependencesince2007.HereceivedthelifetimeachievementawardfromtheİstanbulMedicalChamberin2012forestablishingalgology/painmedicineinTurkey.Authorof25booksinTurkishandeditororco-editorofeightbooksinEnglish,he has published 200 articles,mainly on interventional painmanagement.HisbookPain-RelievingProcedures:TheIllustratedGuide(Wiley-Blackwell2012),co-authoredbyP.PrithviRaj,reflectsthegame-changingdevelopmentsinpain

control over recent years thanks to improved imaging,which allows for bettertargeting of analgesic technique. The book claims to cover all the mostsignificantinterventionalpainproceduresincurrentpractice.

“AnimportantcontributionEFICcanmakeistoincreasetherecognitionofpainpatients’needs.”

Prof.GiustinoVarrassi,MD,PhD,FIPP,EFICPresident2008–2011

EFIC’sfirstItalianPresident,GiustinoVarrassi,ProfessorandChairmanof theDepartment of Anaesthesiology, University of L’Aquila Medical School untilDecember2010andnowGeneralManagerofASLTeramo,apubliccompanyofthe National Health Care Service, was involved in EFIC from its verybeginning.TheFederation,hesays,hadgrown“verymuchovertheyears.”Itsremarkablegrowthmadeastrongsecretariatessential,“butatthesametime,asacentralorganisation,youmustgive recognition toyourpartners, thenationalchapters.”Amongtheactionstakenduringhispresidency,theEuropeanJournalofPainwasdistributedfreeofchargetomembersoftheNationalPainSocieties.Butitwasalsoimportant,Prof.Varrassisays,toreachdecision-makers,manyofwhom still needed to understand the significance of pain, which he terms a“societalproblem”:“IthinkoneofthemaincontributionsEFICcanmakeistoincrease the recognition of patients’ needs, especially those suffering chronicpain, and particularly non-cancer chronic pain – something often forgotten bypoliticiansanddecision-makers.ThisisthereasonwhyIlaunchedthecampaign‘Societal Impact of Pain’. It grew as a result ofmeetings and symposia, evencomingtotheattentionoftheEuropeanParliament.”

“Inaway,IrepresentthehistoryofEFIC,”saysProf.Varrassiwhoalsoservedon IASP’s Task Force on Acute Pain from 1987 to 1992. He became one ofEFIC’sfoundingmembersin1993,andasHonorarySecretaryorganiseditsfirstCongress, inVerona, twoyearslater.HehasbeenMemberof theBoardof theAssociazioneItalianaperloStudiodelDolore(AISD)since1988andservedasitsPresidentfrom2003to2009.In1994,healsofoundedtheEuropeanSocietyofObstetricAnaesthesia(ESOA),presidingoveritfrom2001onwards.Prof.VarrassigraduatedfromRome’sLaSapienzaUniversity,MedicalSchool,in1973.Hecompletedresidency inAnaesthesiaandIntensiveCare in1976atthe same university, and thenmoved to L’Aquila, where he was an AssistantProfessor responsible for the Pain Centre at the University Department ofAnaesthesiology from 1976 to 1985, when he was made a Full Professor.Author of some 400 papers published in international and national scientificjournals,hehasalsowritten43chaptersofbooksonobstetricanaesthesiaandpainmanagement, and edited 28 books and congress proceedings, including atextbookonobstetricanaesthesia.Prof.Varrassihashadconsiderableexposureto different medical cultures around the world, having conducted research atCNR-NIHattheAlbertEinsteinCollegeofMedicine,JeshivaUniversity,NewYork, at Hamburg University, and having served as Guest Professor atMassachusettsUniversityDepartmentofAnaesthesiologyandPainCentre.Hewas also Guest Professor at the University of Tel Aviv Department ofAnaesthesiology and Pain Centre, and Guest Professor at the University ofBarcelonaDepartmentofAnaesthesiology.

“Working on better pain relief and fighting for ourchronicpainpatients.”

Prof.HansG.Kress,MD,PhD,FFPMCAI,EFICPresident2011–2014

FullProfessorofAnaesthesiology,IntensiveCare,andPainMedicineandHeadof the Department of Special Anaesthesia and Pain Therapy at the MedicalUniversity/AKHViennasince20years,HansG.Kressisfascinatedofleadingan organisation which has grown to 36 national chapters and a staggering20,000-plusphysicians,researchers,nurses,psychologists,physiotherapistsandotherhealthcareprofessionals.The prestige of the European Journal of Pain, of events such as the regularSocietalImpactofPainSymposia-whichattractseniorfiguresinmedicineandpolitics-aswellasEFIC’sexpandededucationalactivitiesandthenowbiennialPain in Europe Congresses are, he says, “a big step forward towards publicrecognitionofchronicpainasatruechallenge,notonlytoourpatientsandtheirphysicians, but to our healthcare systems in Europe, the budget holders,decision-makers,andpoliticians.”Past President and current BoardMember of the Austrian Pain Society, Prof.HansG.KresshasaverylongassociationwithIASPandEFIC:TreasureroftheLocalOrganisingCommitteeof the9thIASPWorldCongress1999 inVienna,EFIC Councillor from 2001 to 2005, Honorary Treasurer andMember of theExecutiveBoard until 2011whenhe becamePresident.He says that from theoutset the Federation had kept faith with its trans-national ambitions, and itscommitment to helping the next generation of pain clinicians and researchers.Theseefforts includedsupportfordevelopingpainsocieties inEasternEurope,notleastwithfellowshipswhichallowedyoungdoctorsandresearcherstoattendEFIC’s European Pain Schools, or to be trained and educated duringworkingvisitstorenownedWestandCentralEuropeanpainmanagementcentres.Duringhis presidency, theHeadquartersOfficewas reorganised, the EFICNewsletterrelaunched,andthewebsiteface-lifted.Inordertogetfitfortheinternetera,thewebpresenceofEFICwasexpanded into thenewsocialmediaFacebookandYouTube.Finally, theEuropeanWeekAgainstPainhas been transformed intothe European Year Against Pain, extending the awareness campaign to a fullyear.WiththenewpublishingcontractfortheEuropeanJournalofPainandtheinnovativeagreementwiththePCOKenesonthefutureEFICCongressesuntil2017,EFICiswellpreparedtobethevoiceofpainmedicineinEurope.Lastbutnotleast,thechangeofEFIC´snameinto“TheEuropeanPainFederationEFIC”has further improved its public appearance and underlines its leading role inEurope. “As the current President of EFIC I am very proud of theseachievements and look forward to further contributing, to supporting and toplayinganactiverole inourcampaignfor therecognitionofchronicpainasa

diseaseinitsownright,“hesays.Prof.HansG.KressstudiedforbothhisMDandPhDinGermany,completinghisresidencythere. In1989hereceivedtheCentral-EuropeanAnaesthesiologyAwardfromtheGerman,SwissandAustrianSocietiesofAnaesthesiologyandIntensiveCareMedicine.HehasbeenaFullProfessorattheMedicalUniversity/AKHVienna since 1993.Between 1994 and 2003 hewas also a director ofVienna’s Ludwig Boltzmann Institute for Experimental Anaesthesiology andResearch in IntensiveCareMedicine.Hewas foundingChairman of theTaskForce on Pain Management for the Austrian Society of Anaesthesiology,Resuscitation,andIntensiveCareMedicineandco-foundedtheAustrianSocietyforPalliativeCarein1999,wherehewasalsoaMemberoftheExecutiveBoarduntil 2010. He was awarded the Honorary Membership of the Polish PainSociety in 2010, and in 2013 theHonorary Fellowship of the Faculty of PainMedicineoftheCollegeofAnaesthetistsofIreland(FFPMCAI).DeputyEditorofEFIC’sEuropeanJournalofPain,healsoco-editedAcutePainformany years, and has edited numerous books, and authored over 200 bookchaptersandscientificarticles.Hismultipleclinicalandexperimental researchinterests includepharmacological treatmentofacuteandchronicpain, invasivepainmanagement andneuromodulation in cancer andnon-cancerpatients, andalso neuro- and immunopharmacology of anaesthetics, analgesics and inparticularcannabinoids.

7.THEEUROPEANJOURNALOFPAINTheearlyyears

Prof.FernandoCervero,MD,PhD,DSc,President,IASP

Director,TheAlanEdwardsCentreforResearchonPain,McGillUniversity

FormerEditor-in-ChiefoftheEJP

Establishing anew scientific journal is not an easy task.Tobe successful, thejournal has to acquire a distinct appeal andpersonality, attract the attentionofpotential authors and become a point of reference in its field. And the newjournal has to achieve all of that without an official impact factor, by askingauthorstosubmitpaperstoapublicationwhosefutureisuncertain.The European Journal of Pain (EJP), like the European Federation of IASPChapters (EFIC), were products of the energy and determination of UlfLindblom,whowasPresidentofIASPbetween1990and1993andsubsequentlybecamethefirstPresidentofEFICandthefoundingEditor-in-ChiefoftheEJP.This article is my personal homage to the strength and determination of UlfLindblom,whosucceededinestablishingEFICinspiteofstrongresistancefromoutsideEuropeandwhocreatedtheEJPovercomingobstaclesfromwithinEFICitself.WithoutUlf,therewouldhaveneverbeentheEJPthatweknowtoday.Iwant to review the early years of the EJP from the experience of my owninvolvementintheeventsthattookplaceandintheeffortstogetthejournaloffthegroundandtotakeittothecommandingpositionitoccupiestoday.EFICwasestablishedin1993asafederationoftheexistingEuropeanchaptersofIASPattheinitiativeofUlfLindblom,whoatthetimewasthePresidentofIASP. One of his first priorities with EFICwas to produce a publication thatwouldbecomeitsofficialjournal.Thisinitiativefinallytookshapetowardstheend of 1995, when Ulf became the Editor-in-Chief of the journal, developed

clear and specific objectives for the new journal and started the search for anEditorialBoard.InJanuary1996,UlfaskedmetobecometheDeputy-Editorofthejournalwithaspecialresponsibilityforthebasicsciencepapers.AtthattimeIheldaChairofPhysiologyat theUniversityofAlcala,nearMadrid,where Ihadmoved fromEnglandacoupleofyearsearlier.IacceptedUlf’sofferenthusiasticallyandsobegan a close professional association that lasted for many years and thatdeveloped intoapersonal friendship.Throughout1996wecorrespondedaboutthe new journal – its scope, how to establish a new publication, potentialmembersoftheEditorialBoard–andweagreedtohaveaface-to-facemeetingtofinalisearrangementsattheIASP8thWorldCongressonPaininVancouverinAugust1996.Wemetforacoupleofhoursathisroomatthetopofthecongressheadquartershotel – with a magnificent view of the English Bay in Vancouver and thebeautifulbackdropofthemountainsthatsurroundthebay–andweputtogetheranEditorialBoard,amissionstatementandapublishingpolicy.WeagreedthatthejournalwouldbemultidisciplinaryandinternationalandthatthemembersoftheEditorialBoardwouldbechosenfortheirprofessionalprestige,independentof theircountryoforigin,whichmeant the inclusionofmembers fromoutsideEurope.Publication in the journalwouldbe throughstrictpeer reviewand theacceptanceof apaperwouldbe exclusivelybasedon thequalityof the articlewithnoconcessionstopoliticsorexternalinfluences.TheideawastocreateaninternationallycompetitivejournalverymuchalongthelinesoftheIASPjournalPAIN,thusprovidinganalternativevehicletotheincreasinglylargenumberofstudiesonpainresearchandmanagementthatwerebeingproducedworldwide.We expected submission of papers from Europe to predominate but we alsoencouragedandexpectedsubmissions fromallover theworld, something that,astimeshowed,didindeedhappen.Andthentheproblemsbegan.TheideatheEFICleadershiphadforthejournalwasdifferentthanours.Theywantedanin-housepublicationwithnottoomuchbasic science, focused on European issues, to serve as vehicle for theidiosyncrasies of the variousEuropean chapters. Faxes began to run back andforthbetweenUlfandtheEFICleadershipwithsomesterncommentsastotheroleandauthorityoftheEditor-in-Chief,theinterferenceoftheleadershipintheselection of the Editorial Board and the very philosophy of the journal.Mercifully, thefax technologyof the timemeant thatmostof thesedocumentswereprintedonthermo-sensitivepaperthattodayhasfadedtothepointthatitisalmost impossible to read them; allwe need is a fewmore years and all this

irritation will have, literally, disappeared.My role in these exchanges was tocalmdownUlf,toningdownhisfierycharacterwhilemaintainingtheessenceofourprinciples.Thereisane-mailwhereIcounselUlftobe“balancedandanger-free”;notthesortofadvicethatyouwouldexpectaSpaniardtogiveaSwede.But in the endUlfwon theday and theEJP, under a publishing contractwithW.B.SaundersLtd,wentaheadaswehaddesignedit.Theplanwastopublishthefirstissuein1997.AtthecentreofthisdebateweredifferencesofopiniononthepurposeofEFICandontheroleoftheEJPwithintheorganisation,differencesthatstilllingerontoday.TobetterunderstandtheargumentsitisworthquotingUlf’sownwords,asfounderofbothEFICandtheEJP,inawrittenaddresstotheEFICCouncilin1999on theoccasionof theelectionofanewExecutiveBoard.Hewrote:“InthecurrentcontextitseemsmotivatedtoreconfirmEFIC’soriginandnature.ItmaybeimportanttopointoutthatEFICisnot(Ulf’sitalics)anindependentneworganisation besides IASP but an administrative arrangement for cooperationamongst European IASP Chapters with a certain formal structure to enableconcerted actions in the spirit of IASP. Such arrangements are to organizeEuropeanpaincongresses,setupandrunspecifictaskforcesandpublications,such as the European Journal of Pain, and to pre-sent joint programs with aEuropeanvoice.”Idonot thinkthat therecanbeanydoubtsas toUlf’svisionandpurposewhenhefoundedEFICandstartedtheEJP.Throughout the timewhenwewerestilldebatingabout thekindof journalweweretryingtoproduce,wewerealsosolicitingpapersforapublicationthatdidnotyetexist.Ulfusedhisconsiderableinfluencetopersuadeafewcolleaguestosendpaperstothenewjournaljustgettingstarted.Then,finally,inthespringof1997 the first issue of the EJP appeared in print, containing a couple ofeditorials,areviewpaperandfiveoriginalresearchpapers, threeofthemfromSweden. Rounding out the issue were abstracts of a Scandinavian course onmusculoskeletalpain.Well…itwasastart.

Afax fromUlfLindblom to theauthordated25ofMarch1999 that included the textofhis forthcomingaddresstotheEFICCounciloutlininghisviewsonEFICandtheEJP.Thesectionquotedinthetextofthearticlewastakenfromthisaddress.AlsonotehisreferencetothemeetinginReykjavikdepictedinpage46.

The EJP had just been born but did not yet have a home. The publishers,Saunders, gave us a manager who oversaw operations and a series ofteleworkingeditorial assistantswhomwenevermet inpersonandwithwhomwecommunicated througharudimentarye-mailsystem.Themanuscriptswerereceived by ordinarymail and the logbook of the papers thatwere in review,accepted or rejectedwas kept by hand on anExcel spreadsheet bywhicheverteleworkingeditorialassistantwasondutythatday.Thesystemwasextremelyfragile and depended almost entirely on our capacity to keep on top of thesituationbycloselysupervisingeverythingthatwasgoingon.Thearrangementwiththeteleworkingassistantswasveryunsatisfactory.Oneofthem–whoshallremain unnamed – was clearly incapable of coping with the workload andreacted with a classic case of panic. She froze; and she just stopped doinganything.Thejournalgroundtoahaltandwasindangerofcollapsing.SoUlfand I were called to an urgent meeting in London with the manager fromSaunders to sort things out. We reviewed the mess, paper by paper, a newteleworkerwasappointedandpromisesweremadeofhappierdaysahead.Yet,afew weeks later, the manager from Saunders moved to a different job withanother publisher and a newmanagerwas appointed for the EJPwho did nothavemuchknowledgeofwhatwasgoingon.Andso,wehad to start allover

again.The upheavals in the scientific publishing world also interfered with thedevelopmentof theyoungEJP.SaunderswasboughtbyHarcourtwho in turnwasboughtbyElseviera fewyears laterand the journalwaspassed fromonepublishinghousetothenextwithoutEFICortheEJPhavinganythingtosayintheprocess.Weended,bydefault,beingpublishedbythesamehousethatalsopublishedthetwoothermajorpainjournals:PAINandTheJournalofPain.Butthevariouspublishersdidnotdifferatall intheirshakyeditorialarrangementsinvolvingconstantlychangingteleworkingassistantsandmanagers.

UlfLindblom,TroelsJensenandtheauthor(withJörgenBoivieinthebackground)atadinnerinReykjavikduring ameeting of the ScandinavianAssociation for the Study ofPain (IASP chapter) in the spring of1999.ThiswasthemeetingreferredtobyUlfinhisfaxshownonpage44.ItiseasytospotthefakeVikingashehadthehelmetonbackwards(!)

Inspiteofallthedifficulties,orperhapsstimulatedbythem,theEJPcontinuedto grow and grow. We had the first face-to-face Editorial Board meeting inSeptember 1997 during the EFIC Congress in Barcelona. More papers werebeing received, not only from Europe but also from North America and thejournalwasgoingfromstrengthtostrength.TheEJPalsoproducedafinanciallypositive balance in 1999, its third year of publication, generating a profit forEFICofover£22,000,somethingthatthepublisherstolduswasextremelyrareforsuchayoungpublication.

TheEJPEditorialAssistantbetween2000and2004,MarcelaToro,withayoungmemberof theCerverofamilyduringtheEFICCongressinPraguein2003

Towardstheendof1999,Ulftoldmethathewantedtogiveuptheeditorship.He was getting increasingly tired of the effort and the politics involved andwanted to retire from both. He thought that it was important to maintain thejournal’s philosophy, particularly in the face of possible deviations from ouragreed path and asked me to succeed him as Editor-in-Chief. Thus began acomplexdiplomaticandsomewhatbureaucraticprocessthatendedinSeptember2000withmyappointmentasUlf’ssuccessorbytheEFICCouncil.BythentheEJPhadbeenappearingforonlyfouryearsforasumtotalof16issues.Mycloseassociation with the EJP as Ulf’s deputy throughout these years meant that Iknewthejournalverywellandcouldtherefore takeupmynewdutieswithoutdifficulty.Mymainprioritieswere toadapt the journal’sorganisationandstructure to itsincreasingly relevant position in the field and to maintain the philosophy ofquality, multidisciplinarity and worldwide circulation that we had establishedfromthestart.TheEditorialBoardwasrenewedandexpanded,differentsectionswere identified and Section Editors appointed: Eija Kalso for clinical papers,Chris Main for psychology and Rolf-Detlef Treede for basic science studies.AlsoanEditorialOfficewasfinallysetupclosetotheEditor-in-Chief.Forthistask, I had the good fortune of meeting and appointing Marcela Toro, an

experiencedadministrator fromChilewhohad justmoved toMadrid.MarcelabecamethesouloftheEJP,managingalldocumentsandcorrespondenceforthejournal, communicating with reviewers, members of the Editorial Board andauthorsandessentiallyservingasthevisiblefaceofthejournal.Shewas–andstillis–akindandgentlewomanwhomanagedtodoaverydifficultjobwithasmile always on her face and who became the e-mail friend of the entireEditorialBoard.Manyofthemwereverygladtomeetherinpersonatourface-to-faceEditorialBoardmeetingduringtheEFICCongressinPraguein2003.Intheyear2000theEJPincreaseditsfrequencyofpublicationfromfourissuesto six issues per year, to accommodate the increasing number of high qualitysubmissions.Alsoin2000thejournalreceiveditsfirstimpactfactorever;smallbut perfectly formed. This meant that authors could now send papers to thejournalwith the knowledge that these publicationswould be counted for theirCVs and sources of funding. Having an impact factor is amust for any self-respecting journal andwemanaged to earn ours in the shortest possible time.TheEJP also received a new lease of lifewhenwenegotiated a new contractwith Elsevier in 2003, under the very able guidance of the then Chair of theEFIC Publications Committee, Beverly Collett. She engaged a firm ofknowledgeable and shrewd London lawyers who gave us good advice on thevarious bids received andmanaged to extract fromElsevier a very favourablepublishing contract that included a guaranteed royalty and therefore a steadysourceofincomeforEFIC.Everythingwasgoingverywellwhenanewdisturbance–inthiscasepersonal–appearedontheEJPhorizon.In2002Iwasofferedtheopportunity to join thepain research community atMcGillUniversity inMontreal and I accepted theoffer.ThismeantthattheEditor-in-ChiefoftheEuropeanJournalofPainwouldbe based in North America, a situation that was perceived by some asundesirable. I therefore informed the then President of EFIC, Harald Breivik,that Iwasputtingmyeditorshipathisdisposal.Haraldaskedme to remainasEditor-in-Chiefuntilasuitablereplacementcouldbefound.Thusbeganaperiodof more than three years when the Editorial Office was being managed byMarcela in Madrid while I was physically based in Montreal; back to theteleworking times, though in thiscase thedaywasalways savedbyMarcela’sskills and superb professionalism.Finally, in 2004,HermannHandwerkerwasappointedEditor-in-ChiefandmyworkwiththeEJPendedwiththelastissueofthatyear,afternineyearsofcloseassociationwiththejournal.Looking back on these years I can saywithout any doubt, that setting up andrunningtheEJPwasoneofthemostsatisfyingaspectsofmyprofessionallife.

The privilege of working closely with Ulf and of developing a personalfriendshipwithhimispriceless.ThefriendshipandhelpthatIreceivedfromkeypeople, likeMarcela,Beverly andmanymembersof theEditorialBoardwereundoubtedly the main reasons for the success of the journal. Seeing a newpublicationgrowfromnothingintoaprestigiousscientificjournalisenormouslyrewarding.Andhavingproducedandofferedausefulservicetomycolleaguesin thepain researchandmanagement fieldmadeall theeffortsanddifficultiesworthwhile.Andfinallyandwholeheartedly,Igivemythankstothemanypeople-authors,SectionEditors,membersoftheEditorialBoard,reviewersandadministrators-whohavecontributedtomakingtheEJPtheoutstandingpainjournalitistoday.

Movingonfrompaperworktointernet

Prof.Dr.HermannO.Handwerker,Editor-in-ChiefoftheEJP

Dr.BettinaHaake-Weber,ManagingEditoroftheEJP

Inthelastissueofvolume8oftheEuropeanJournalofPainFernandoCerverowrote an editorial with the title “The end of the beginning” summarising hishighlysuccessfultimeasEditor-in-Chiefofthisjournal.Somemonthsbefore,Iwas elected as his successor by a committee of the EFIC Executive Board. IrememberthesessioninParisandinparticulartheparticipantsHaraldBreivik,theEFICPresident,andFernando.Wediscussedthefutureofthejournal.Itwasour clear aim to develop the journal further as a high quality internationalpublication platform covering all facets of pain research from molecularmechanisms to psycho-social processes. As I wrote in my inaugural editorial(EJPVol.9,1):Originalbasicscience,experimentalhumanstudiesandclinicalresearchpapersshouldbeaccepted–continuingwhereFernandohadleftoff.Tostartwith,IhadtoselectanewEditorialBoard,sinceallbutoneofFernando´s SectionEditorswere no longer available.BeverlyCollet,who had done somuchtohelpthejournalaschairoftheEFICPublicationCommittee,agreedtojoin the board; Rolf-Detlev Treede, neuroscientist fromMainz, Germany, wasstillavailablefromFernando´screw.Later,hechangedtothejournalPAIN.Thefollowingindividualswererecruitedinthisperiod:MariaAdeleGiamberardino,clinical neuroscientist from Chieti, Italy; Per Hansson, neurologist from theKarolinskaInstitute,Stockholm;andChristianeHermann,clinicalpsychologistfromGiessen,Germany.ThesefourbecametheinitiallysmallgroupofSectionEditors. I was particularly lucky that Bettina Haake-Weber, a young medicaldoctor from the same city as my university, agreed to become my Editorial

Assistant (nowManaging Editor). In contrast to me, she was experienced inworking with a scientific publisher. She became the soul of a small EditorialOffice in Erlangen. In this function she provided the continuityMarcela Torohad provided before, while the contact persons on the publisher´s side keptchanging,albeitnotasdramaticallyasduringFernando´stime.Stillin2004BettinaandIvisitedFernandoandhischarmingandhighlyefficientEditorialAssistantMarcelaToroinMadrid.Atthistimetheheartoftheeditorialwork was “THE BOOK”, a daunting folio which contained notes on allmanuscriptscomingbymailandtheirfateinthecourseofeditorialprocessing.Itwasclearfromthebeginningthat thenewEditorialBoardandOfficewouldnotcontinue“THEBOOK”,buttransfertheeditorialprocesstotheinternet,thusgreatlyacceleratingthejournalturnaroundtimes.TheplatformwasprovidedbyElsevier´s “Editorial Manager” (EM), later “Elsevier Editorial System”, nowbacktoEM.Withthefirstissueofvolume9,westartedaprocesswhichstillhasnotcometoanend.Thisjournaloncebasedentirelyonpaperwork,mightwellend up in a few years as a journal strictly for the internet.As a first step, allarticles “in press” are available online shortly after acceptance and thereforecitableusingaDOIsince2006.In2005wereceived300manuscriptstoprocess.Fiveyearslater,thenumberofsubmissions had more than doubled. In 2005, we published 786 pages in sixissues(79articles).Wehadtoincreasethenumberofissuestoeightalreadyinthefollowingyear.Finally,in2009wewenttotenissuespervolume.Withtheincreasing floodof submissions itbecamedifficult toprevent the journal fromburstinganditscontentfrombecomingdiluting.Burstingwaspreventedbyourcontract with Elsevier which limited the number of pages with “editorialcontent”.In2011thelimitwas1.160publishedpagesperyear.Inthisyearwepublished 149 papers, almost twice as many as in our first year. During thisperiod of fast growth the backlog between the appearance of a paper on theinternetandinaprintedissueremainedalmostconstantlysixtoeightmonths.Fortunately, the Section Editors and the Editor-in-Chief were successful inmaintaining a high standard for the accepted papers. Our acceptance rateoscillatedbetween20%and25%overtheyears.FortheEditor-in-Chiefitwasnotalwayseasytosignalltheserejectionletters.Noauthorisamusedwhentheresultsofhisarduousworkarerejected.Notthebestwaytomakefriendsamongyour colleagues! In 2005, most of the papers submitted came from Europeancountries.UnitedKingdomrankedfirst,followedbyGermany,theNetherlandsand Italy.However, by2006 submissions from theUnitedStateswere alreadyrankingfourth.

AsIunderstandit,andapartfrommyriadotherconsiderations,theinaugurationofEFICandsubsequentlyoftheEuropeanJournalofPainwasalsoareactiontothe previous launching of the American Pain Society and of The Journal ofPain.Atthattimeitbecameobviousthattherewasroomforotherhighrankingpublicationplatforms forpain research,besidesPAINand the JournalofPain,undertheauspicesofIASP.Nowadays,morethanadecadelater,about65%ofthe articles published in The Journal of Pain come from North America andabout20%fromEurope(figuresfrom2012).Inthesameperiodabout70%ofthe articles published in theEJPwere fromEuropean authors, and only about10% fromNorthAmericans. Publications from the rest of theworld aremoreevenlydistributed,thoughtheEJPpublishedslightlymorepapersfromAsiaandAustraliainthisperiod.

RegionaldistributionofpaperssubmittedtotheEuropeanJournalofPainin2010

I amnot happywith this distribution and one of the reasons for changing thepublisherin2011wasthefeelingthatElsevier,bypublishingbothjournals,hada tendency to promote each of them only in its region. More competitionbetween publishers seemed to be a welcome move. Of course, neither ourjournal, nor any one of the other, about a dozen, sientific journals having“European”intheirtitle,usethistitleinapolitical,regional,orevenparochialway.TheselectionofourSectionEditorsisnotregionallybound,butguidedbytheir expertise. There is no rule to prevent a non-European from becoming

Editor-in-Chiefofthisjournal.ComingbacktothedevelopmentoftheEJP:Whilethejournalwasgrowinginthe years from2005 to 2011,we experienced a continuous rise of our impactfactor, with a preliminary peak of 3.94 in 2011. This was not an easyachievement considering the journal almost doubled the number of papers itpublishedinthisperiod.Though the journal was making profit for EFIC, our financial situation wasalwaysmore difficult than that of e.g. The Journal of Pain, or PAIN, for thatmatter.Asmentionedabove,EFICisnotasocietybutafederationofsocieties.SincetheEJPisnotasocietyjournal,benefitingfromcompulsorysubscriptionsbysocietymembers,thesmallnumberofprintedcopieswasalwaysaproblem.EFIC invested a considerable portion of the royalties from the journal tosubsidise individual subscriptions of the printed version of the journal fordelegates of the EFIC Congresses in Istanbul (2006) and Hamburg (2011).However,theboostinthesizeoftheprintededitionwasshortlived.Theofferofcost-free subscriptions of the internet version of the EJP to members of thenationalEFICchaptershasprovenmorelasting.AnotheronlymoderatelysuccessfulattempttopromotetheEJPwasthelaunchof a sister publication: European Journal of Pain – Supplements. This journalwasmeanttoserveforthepublicationofconferenceproceedingsandothertypesof sponsoredmaterial.While theEJP-Supplements flourished for a few years,theywerealsoasourceofconcern.Peoplepublishingtheirmaterialinthisorganwere disappointed that the articles were not listed in MEDLINE, while theparent journal occasionally had difficulties, when many articles from aconferenceintheFarEast(whichneverreceivedanyattentionintheliterature)wereerroneouslycountedincalculatingitsimpactfactor.Iwroteaneditorialonthisincident(“Impactfactorblues”,EJP14/1,2010).

In response to the steady growth of the journal the Editorial Board had to beaugmentedandnewexpertsforemergingfieldsrecruited.TheseSectionEditorswere: StephenMorley, clinical psychologist from Leeds, UK; Frank Birklein,neurologistfromMainz,Germany;JoernLoetsch,clinicalpharmacologistfromFrankfurt, Germany; Fiona Blyth, epidemiologist from Sydney, Australia;Jennifer Laird, experimental pharmacologist from Montreal, Canada; DidierBouhassira, experimental and clinical neurologist from Paris, France; LuisVillanueva, neurobiologist from Paris, France; Ted Price, experimentalpharmacologist from Phoenix, Arizona, U.S.; Bart Morlion, anaesthesiologistfromLeuven,Belgium.ThepresentEFICPresident,HansGeorgKress,servesthe Editorial Board as Deputy Editor. I am extremely grateful to all of them.Theydidandstilldoamarvelousjob.Whatwouldajournalbewithoutitsreviewers?Actually,wehave4,661namesfromallovertheworldinourdatabase,allsuggestedbyourverybusySectionEditors.Likeotherjournalsweinvitefourpersonsatatime,hopingthattwoofthemwillagreewithinafewdays,toreviewapaper.Asonemightimagine,itsometimes is necessary to remind reviewers of an invitation or of theiroutstanding review. In 2012, we sent out 2,129 invitations to 1,235 differentreviewers and 932 reviews and re-reviews were received. Following thejournal’s growth, the list of the members of the Advisory Editorial Boardbecame longer. At present, this board consists of 71 scientists, mostly from

Europe, but also from other parts of the world (see “Editorial Board” on thejournal’swebsitewww.europeanjournalpain.com).Onceayear,theEditorialBoardmeetswithrepresentativesofourpublisher.Informer times these meetings took place in Amsterdam, in recent years inHamburg,BerlinandVienna.TogiveanimpressionoftheintenseatmosphereafewsnapshotsareshowntakenattheBerlinmeeting2012.At these meetings, we had lively discussions on editorial procedures, on thechanging landscape of scientific publishing, and importantly, on the futuredevelopment of the journal. These face-to-facemeetings are indispensable forengenderingteamspirit,thesourceoflifeforthejournal.

The members of the Editorial Board during the meeting in Berlin in 2012 obviously mulling over thejournal.Fromlefttoright:BettinaHaake-Weber,PerHansson,ChristianeHermann

In 2011, EFIC decided to change the publisher. We moved from the largestscientificpublishinghouseElseviertothesecondlargestpublisherofscholarlyjournals,Wiley-Blackwell.Althoughwehadagoodworking relationshipwithKarenaGrundy,ourpartneratElsevier, therewereseveralreasonsas towhyachangewasdesirable.Nottheleastonewehaveexplainedabove.Startingwithanew publisher entails adapting to another publishing culture. Though Wileyofficerswereveryhelpfulinthistransitionprocess,problemsstillarose.Elsevierstopped typesetting four months before their contract ended. Their database“ScienceDirect”stoppedincludingnewarticlesfromourjournal.WhenournewcontractwithWileybeganon1 January2012, theywerebusy transferring the

journalwith all back volumes and articles in press into their database “WileyOnlineLibrary”asquicklyaspossible.However,signingnewcontractswiththeimportant libraries of public institutions tookmore time.Throughout 2012 theaccessibility of our journalwas impeded.Wedid our best, to compensate thiswithagenerousofferoffreesubscriptiontotheinternetversionforallmembersof national chapters. At the start of 2013 the EJP was included in Wiley´spackage-saletopubliclibrariesandthisproblemeased.

EditorialBoardmeeting inBerlin in2012, theother sideof the table.From left to right:JoernLoetsch,HansG.KressandDidierBouhassira

After one and a half yearswith the newpublisher,we nowhave an attractivescientific journal. We are very grateful to all our coworkers on the EditorialBoard, to the EFIC Council and Executive Board, and in particular to EFICPresidentHansG.Kress,who fully supports the journal and also collaborateswithusontheeditorialwork.Wearealsogratefultotheresponsibleofficersofour publishers: to Karena Grundy for the bulk of time with Elsevier, and toRichardHughesfortheinitialperiodwithWiley.WeareinparticulargratefultoAmandaMcLean-Inglis, our present liaison atWiley. She is always efficient,knowledgeableandextremelyhelpful.Cooperatingwithherisencouraging.The landscape of scientific publishing is changing rapidly. We have to beflexible in responding tonewchallenges. In thisprocess,wehope tomaintainthe European Journal of Pain as an attractive publication platform in the topgroupofjournalsdedicatedtothescienceofpain.

TheEditor-in-Chiefof theEJP,HermannHandwerker, trying tocapture thesplendid ideasvoicedbyhiscolleagues

8.THEEUROPEANWEEKAGAINSTPAIN

The annual European Week Against Pain (EWAP), one prong of the EFICinitiative Europe Against Pain, was launched in the European Parliament inOctober 2001 with the declaration: “Pain is a major healthcare problem.

Although acute pain may reasonably be considered a symptom of disease orinjury,chronicandrecurrentpainisaspecifichealthcareproblem,adiseaseinitsownright.”Every year since then, the national and regional EFIC chapters have heldactivities to sensitise stakeholders, the medical community and the generalpublic about the issue of chronic pain. From 2012 onwards, the event hasbecome even more ambitious and been transformed into the European YearAgainstPain(EYAP).

2001EFIC chapters organised local awareness events, with public lecture series,articles in newspapers and magazines, TV and radio interviews with painexperts,aswellasfund-raisingmarathonsandsponsoredwalks.

2002EFICchaptersbuiltontheirexperiencesin2001toexpandtheirlocalactivities.

2003ThethirdEuropeanWeekAgainstPainwaslaunchedduringtheEFICCongressPaininEuropeIVandfocussedonpublicisingnewdata.AEuropeanwebcastreceived thousands of hits, with follow-ups and reviews in numerouspublications.Thebiggest-ever surveyofpatients inchronicpain,organisedbytheBritishPainSociety,wasreleasedinOctobertomarkthecampaign.46,000people were interviewed in 16 countries. The survey found that 19% of the

European population suffered chronic pain, one third of them experiencingchronicpainatalltimes.

2004EFIC joined forces with IASP and theWHO for a world-wide effort and thelaunchof theGlobalDayAgainstPain inGeneva.EFIC’s thenPresidentProf.HaraldBreiviksaid:“Chronicpainisoneofthemostunderestimatedhealthcareproblemsintheworldtoday,causingmajorconsequencesforthequalityoflifeofsufferersandamajorburdenonthehealthcaresystemintheWesternworld.”SirMichaelBond,PresidentofIASPatthattime,arguedthat“painreliefshouldbeahumanright,whetherpeoplearesufferingfromcancer,HIV/AIDSoranyotherpainfulcondition.”

2005ThetopicchosenfortheEuropeanWeekAgainstPainwas“PainintheElderly”.Thecampaignaimedatraisingawarenessaboutapressingproblem-theworld’srapidly ageing population, with over-80-year-olds the fastest-growing group.Generalevidencesupportsanage-relatedincreaseinpainprevalence.InadditiontomediacampaignsandlocalawarenessinitiativesorganisedbyEFICchapters,a questionnairewas devised byEFICofficials to gather information about theday-to-daymanagementofpainamongstelderlypatients.Thecampaignstressedthatpainamongolderpeoplehadbeenunder-treatedfordecades.

2006Withthemotto“PaininOlderPersons”,EFIC’scampaignagainfocussedontheelderly, against a background of ever-more alarming statistics of an ageingpopulation of whommore than half of those living at home suffered chronicpain,often long-termandunder-treated.Thecampaigninsisted thatpain in theelderly was neither untreatable nor a “normal” part of the ageing process. Itcalled for better professional education, dedicated research, and better painmanagementstrategiesforolderpeoplewithspecialattentiontothoselivinginnursing homes or hostels, especially those suffering from dementia. EFICunderlinedtheproblemthattheoverwhelmingmajorityofpaintreatmentstudiesand trials have been conducted on young adults and therewas little scientificevidencetosupportmostofthecurrentlyacceptedtreatmentsforolderadults.

2007EFIC’sgoal in the2007EuropeanWeekAgainstPainwas to increasegeneralawarenessoftheuniquenatureofpaininwomen.Acomplexoffactorsappearsto underlie the unique nature of pain in women: hormonal, genetic,psychological, and socio-cultural. Women are more sensitive than men tonoxiousstimuliandhavelowerpainandtolerancethresholds,oftenexperiencingmore intense and long-lasting pain than men. Their atypical patterns of painmakefortrickydiagnosisanddelaysintreatment.Althoughmorelikelytoseekmedical care than men for painful conditions women appear to receive lesstreatmentfortheirpain,being1.5timesaslikelytobeunder-treatedforcancerpain. Medical underestimation of women’s suffering often leads to non-malignant pain being considered as “normal” or “physiological”. EFIC alsoarguedthatawarenessofnationalparticularitieswasafundamentalsteptowardsundertakinginitiativesataEuropeanpoliticallevel.

2008TheEuropeanWeekAgainstPainin2008wasdevotedtofibromyalgia(FMS).Prevalence figuresvary from2%in theUSAandFrance to4%inSpain,withwomenaffectedseven tonine timesmore often thanmen.Sufferersareoftendismissed as “neurotic” or “imaginary” patients because their pain has noidentifiable “cause”, and because of the high incidence of associated affectivedysfunction.Through awareness activities by regional and national chapters, EFIC drewattention to the fact thatalthoughFMSdoesnot threatenpatients’ lives, it cancauseseveredisability.EFIC’sgoalwastoincreasethegeneralawarenessoftheuniquenatureofpaininfibromyalgia,andtherightofpatientstoreceivespecificattentionandspecialisedtreatment.

2009The aim of the 2009 campaign ofEFICwas to educate health-care providers,government leadersand thegeneralpublicabout the issuessurroundingoneofthemost importantpainco-morbidities–depression.Peoplewithchronicpainhave three times the average risk of developing psychiatric symptoms anddepressedpatientshavethreetimestheaverageriskofdevelopingchronicpain.

People in pain who are also suffering from depression typically use medicalserviceswithgreatfrequency,eveniftheyhavenosevereunderlyingillness.Butthat does not mean they receive better treatment. Pain slows recovery fromdepression,anddepressionmakespainmoredifficulttotreat.Worse,bothpainand depression feed on themselves by changing both brain function andbehaviour.

2010ThetenthanniversaryyearoftheEuropeanWeekAgainstPainsawacampaignwhichfocussedonthesocietalimpactofpain.EFICunderlinedthatpainwas“aproblem in its own right, not just an indicator of an underlying disease ordamaging process, but one which exacts a great toll from individuals andsociety.” National and regional activities were aimed at discussing the hugesocial burden pain represents, including absenteeism, disability allowances,assistedcare,informalandfamilycare.Itwaspointedoutthatpainpatientswhohave received treatment cost society much less than untreated patients. Theenormous costs in individual suffering, and the resulting economic burden,meant that policymakers should adopt amuchwider, strategicperspective, theEFICcampaignerssaid.

2011The2011campaigncalledforarethinkofthevaguedismissalofmostbackpain

as “non-specific.” At the launch of the European Week Against Pain it waspointed out that backachewas “a silent epidemic affecting tens ofmillions ofEuropeans.” Categorisation of 95% of back pain as “non-specific” was“unsatisfactory, unserious, and unscientific.” The enormous socio-economicburdenofthisconditionwasthereasonforEFIC’sdecisiontoextenditsannualcampaign to an entire year. Almost every European experiences back pain atsomepoint.EFIC presented an ambitious Plan of Action to fight chronic back pain. Itincludedeffortstoraisegeneralawarenessaboutthenegativenaturalcourseofbackpain,informationcampaignsabouttheimportanceofkeepingupphysicalactivitydespitepain,designofanewandappropriateclassificationofbackpain,promotionofbetterresearch,andthedevelopmentofmoreeffectivetreatment.

9.THEEUROPEANYEARAGAINSTPAINInOctober2012,EFIClaunchedthefirstEuropeanYearAgainstPain(EYAP)inBrussels. Building upon the successes of 11 EuropeanWeeksAgainst Pain, itwas decided to expand the initiative and to devote an entire year to providinginformationononespecific,widespreadformofpainorparticularissuerelatedtopain.This isdone incoordinationwith the InternationalAssociation for theStudyofPain(IASP).Themostimportantgoalwiththeextendedformatofthecampaignistopresentpaininallitsaspectsandalsoinallitssocialconsequences.Indoingso,EFICwantstosupportthoseaffectedandinformthebroadpublicandthemedia,butalsogiveawake-upcalltopoliticaldecision-makersintherealmsofhealthcare,socialservicesandfinance.InthefirstEuropeanYearAgainstPainfromOctober2012toOctober2013,thetopicalfocuswasonatypeofpainthatpracticallyeverypersonhasexperiencedinitsacuteformandthatisclearlyunderestimatedinitschronicform–visceralpain.Acute visceral pain can be extremely unpleasant and at times life threatening.However,chronicvisceralpaincanalsoposeasignificantburden.Acutevisceral

painissecondonlytotraumaasareasonforpatientsvisitingemergencywards.Although of statistical significance, this category of pain has been subject tomuchlessresearchthanpainfromtissuedamageornerveinjuries,forexample.Thereisnoadequatetreatmentforchronicvisceralpainsinmanycases,unlikefortheacuteformsofthispain.Thatiswhythisdisorderisoftenconnectedwithfar-reachingstress,whichinitself,receivestoolittleattention.WiththeEuropeanYearAgainstVisceralPain,EFICsetaspecialprioritytohelpthose whomay have been silently suffering for a long time. It was aimed atpointingouttothemwhichproblemstheirsymptomsmightbeindicatingandatmotivatingthemtoseekoutassistanceinthediagnosticandtherapeuticsystem.That is why EFIC made available thorough fact sheets on different types ofvisceralpainatwww.efic.org.ThesecondEuropeanYearAgainstPainfromOctober2013toOctober2014isdesignedtofocusontheimportanttopicoforofacialpain.

10.SOCIETALIMPACTOFPAIN(SIP)TheEFICinitiative“SocietalImpactofPain”(SIP)isaninternationalplatformjointlycreatedwithGrünenthalGmbHin2010.Itaimsat- raising awareness of the impact that pain has on our societies, health andeconomicsystems;-exchanginginformationandsharingbestpracticesacrossallmemberstatesoftheEU;- developing and fostering European-wide policy strategies and activities forimprovedpainmedicineinEurope.The platform provides opportunities for discussion between health careprofessionals, pain advocacy groups, politicians, insurances, representatives ofhealthauthorities,regulatorsandbudgetholders.

SIP2010UnderthescientificleadofEFIC,andwiththefinancialandlogisticsupportofthe pharmaceutical company Grünenthal, the first SIP Symposium in 2010 inBrusselsbroughtmorethan200healthexpertsandrepresentativesofEuropeanhealth authorities togetherwith budget holders, strategic decision-makers, andotherstakeholders.The logic behind establishing SIP was explained by the then EFIC PresidentProf.GiustinoVarrassi,whosetoutsomeoftheharrowingstatistics.InEurope’sfivelargestcountriesalone,France,Germany,Italy,SpainandtheUK,51.8millionpeoplewereestimated tohave recently sufferedpain.“Thesocialand economic impact of lowbackpain alone should be enough to send alarmbells ringing for public policy-makers,” said Prof. Varrassi. “But recent datashowthatabiggroupofpainpatientsisnotadequatelytreated,becausepainisnotfullyrecognisedasanimportanthealthissuebymanyofthenationalhealthcaresystems.”

There was a broad consensus that treated pain patients cost nationalgovernments,economies,andsocietiesmuchlessthanuntreatedpatientsdo.TheSIP 2010 Symposium directly tackled the huge pain-related social burden ofabsenteeism,disability allowances, assistedcare, and informal and familycareforthefirsttime.

SIP2011Thesuccessof2010wasfollowedbyafurthereventin2011.TheaimsofSIP2011 were endorsed by more than 85 international organisations, institutions,andpatientadvocacygroups.TheSIP2011SymposiumwasalsoaddressedbytheEuropeanCommission’sthenHealthCommissioner,JohnDalli.Debates delved into aspects of the societal impact of pain, from its definition,prevalence and demographics to the qualitymeasurement, costs and resourcesinvolved. In a crucial step, theparticipants agreedonaRoadMap forAction,which challenged European governments and EU institutions to acknowledgechronicpainasadiseaseinitsownright.ItnotedthelimitedeffectonEUpolicyofEFIC’s2001DeclarationonPaintenyearsbefore.TheRoadMapcalledonEuropeangovernmentsandEUinstitutionsto:1.Acknowledgethatpainisanimportantfactorlimitingthequalityoflifeandshouldbeatoppriorityofthenationalhealthcaresystem.2. Activate patients, their families, relatives and care-givers through theavailabilityofinformationandaccesstopaindiagnosisandmanagement.

3.Raiseawarenessofthemedical,financialandsocialimpactthatpainanditsmanagementhasonthepatients, theirfamilies,care-givers,employers,andthehealthcaresystem.4.Raiseawarenessoftheimportanceofprevention,diagnosisandmanagementofpainamongstallhealthcareprofessionals,notablythroughfurthereducation.5.Strengthenpainresearch(basicscience,clinical,epidemiological)asapriorityin the EU framework programme and in equivalent research road maps atnationalandEUlevel,addressingthesocietalimpactofpainandtheburdenofchronicpainonthehealth,social,andemploymentsectors.6.EstablishanEUplatformfortheexchange,comparisonandbenchmarkingofbest practices betweenmember states on painmanagement and its impact onsociety.7. Use the EU platform tomonitor trends in painmanagement, services, andoutcomes and provide guidelines to harmonise effective levels of painmanagementinordertoimprovethequalityoflifeofEuropeancitizens.By the end of the year there were clear signs that the initiative was gainingtraction.November2011sawthelaunch,againintheEuropeanParliament,ofapan-European Alliance of Pain Patient Advocacy Groups, the Pain AllianceEurope (PAE). This network of 18NGOs representing 11 European countriescommitteditselftoputtingtheRoadMapontheEuropeanpoliticalagenda.

SIP2012Inthemonthsthatfollowedtherewerefurtherindicationsofwidespreadsupport.The aims of the SIP 2012 Symposium, held in Copenhagen, were officiallyendorsed by the Italian Presidency of the Council of Ministers. One of theSymposium’smainpurposeswastomonitorprogressinimplementingtheRoad

MapforAction.InhisopeningspeechtoSIP2012,EFICPresidentProf.HansG.Kresssaidthatdespite the “tremendous challenge” posed by theEU’s ageing population, andthegrowinginthenumberofpeoplesufferingfromchronicpain,itstilldidnothave a high enoughpriority for policy-makers.But judging from reports fromEFICmembers,therewasprogressintranslatingthesevenstrategicgoalsoftheRoadMapforActionintolocalandnationalactivities,hesaid.Tworeportspresentedtothe2012Symposiumgaveevidencethatchronicpaindeservedahigherpriority.“ReflectionprocessonchronicdiseasesintheEU–the role of chronic pain” showed the strong link between increased age andchronic pain, which affects half of those aged over 65. A second report,“HealthyageinginrelationtochronicpainintheEuropeanUnion”,confirmedthatpainpreventionandtreatmentcouldbeapromisingapproachtoimprovingquality of life, and should therefore form part of the European Commission’sEuropeanInnovationPartnershiponActiveandHealthyAgeing.

SIP20132013 found SIP back in Brussels and well-established as a forum. Based onpromising national policies on pain management and the feedback of SIPstakeholders,EFIC and theSIPProgrammeCommittee decided to concentrateon twomajor topics in theRoadMapforAction–quality indicators,andbestpracticesforreintegratingchronicpainpatientsintotheworkforce.Achangeofstructure was also decided, with the establishment of two FocusGroups. TheFocusGroups tookplace as an associated event of the IrishPresidencyof the

CounciloftheEU.Asbecameparticularlyclearduring theFocusGroup1meetingondevelopingqualityindicatorstomeasuretheresultsofimplementingadequateaccesstohighstandards of pain management, different European countries with differentEuropean healthcare systems have distinct requests and conditions. SIPRecommendations for aEuropean setofquality indicatorswerediscussed andagreeduponbyFocusGroup1.TheserecommendationswillhavetobedefinedinmoredetailbyanEFICTaskForce.NexttotheEuropeanrecommendations,alsocountry-specific,nationalrecommendationsshallbegenerated.ThetopicofFocusGroup2wastoshowthesignificantimpactofchronicpainontheEUworkforce.BaseduponbestpracticeprojectsfromfivedifferentEUcountries,aProposalforActionforbringingchronicpainpatientsbacktoworkwasdiscussedandagreedupon.It calls on European governments “to promote and implement preventivemeasures and rehabilitation programmes for the re-integration of chronic painpatients into the workforce to secure a healthy and productive employmentsector”.

11.THEEFICPAINSCHOOLSTheEFICPainSchoolKlagenfurt-PörtschachProf. Rudolf Likar, Department of Anaesthesiology and Intensive CareMedicine,KlagenfurtHospital,Austria;Dr.ReinhardSittl,InterdiscipinaryPainCentre,Erlangen,Germany

CourseDirectorsRudolfLikar(left)andReinhardSittl

TheEFICPainSchoolKlagenfurt/Pörtschachwasfoundedin2007.Butalreadysome20yearsago,wehadbeguncompilingeducationalmaterials,initiallyforuse by non-pain specialists in Austria and Germany. Our approach combinedtheoretical knowledge with practical advice and an interactive teaching style.Our “PainCourses” inGermany andAustriawere such an immediate successthatwesoonfoundithardtosatisfythedemandforthem.

GenesisoftheEFICPainSchoolideaWe decided to offer the courses in different languages and developed aninteractive, professionally-designed CD-ROM as a working tool for courseparticipants. In its present form the course bears the imprint of distinguishedpainspecialists,whohavenotonlyupdatedandadaptedtheoriginalmaterialforother countries, but also provided a delightful experience of collaboration andfriendship.OverrecentyearsourteamsatErlangenandKlagenfurt,alongwithmanyotherscientists and pain specialists, have helped to improve the new “PainCompendium”,anInternetcourse,whose27chaptersnowconstitutethebasicteachingmaterialatthePainSchool.In 2007, SerdarErdine andGiustinoVarrassi proposed adapting the format ofoursuccessfullocal“PainCourse”tocreatean“EFICPainSchool”soitcouldbeusedbyyoungdoctorsindifferentEuropeancountries.ThecurrentEFICPresident,HansG.Kress,hascontinuedEFICsupportforthePain School at Klagenfurt/Pörtschach. He made important contributions, in

cooperation with the EFIC Educational Committee, to developing clear rulesaboutwho,andinwhichcountries,shouldgetsupport.

ConferencebuildinginPörtschach

FormatandcontentWehavefoundthecomputer-basedinteractivecoursewedevelopedforEFICtobemore effective than traditional teachingmethods for intensive learning andknowledge retention. Discussion and sharing of solutions with both otherparticipantsandthelecturerisencouraged.Ouraimistoteachbasicknowledgeaboutpainanditsmanagementandtogiveparticipantsallthematerials(CDs,chartsetc.)theyneedtoactasinstructorsanddisseminatorsofinformationthemselvesintheirhomecountries.Interactivesessionsonacutepain,cancerpain,neuropathicpain,headache,painintheelderly,andmusculoskeletalpainarerunbyRudolfLikar,ReinhardSittl,Stephan Schug, and their colleagues from the University of Erlangen andKlagenfurtHospital.Several guest lectures on non-opioids, acute pain, rheumatology pain,cannabinoidsandpsychologicaltreatmentstrategiesetc.havealsobeengiveninrecentyearsbydistinguishedcolleagues(H. G. Kress, Alexey Danilov and his brother Andrei, M. Ausserwinkler, M.Barbosa,A.KarkinTais,A.Kopf,N.KrčevskiŠkvarč,G.Varrassi,P.Moore,H.Sprott,andG.Müller-Schwefe).OnWednesdayafternoons thereareopportunities togoonanexcursion in theregion.

PainSchoolparticipants

The EFIC Pain School at Klagenfurt/Pörtschach is aimed at young “non-painspecialists” and covers the main aspects of pain management. Participantsacquirebasic informationonphysiological andpharmacologicalprinciplesandintervention procedures aswell as, for example, non-pharmacological therapy,acute/postoperative pain, basics in cancer pain therapy, and neuropathic painsyndromes.Treatmentofspecialpainsyndromessuchasvisceralpain,arthritisandchronicwidespreadpainisdiscussedinconjunctionwithactualcases.Overthepastsevenyears150youngdoctorshavetakenpartinacoursewhichhas become a real international event, coming fromAlbania, Austria, Bosnia,Croatia,CzechRepublic,Denmark,Estonia,Germany,Greece,Hungary,Israel,Lithuania, the Netherlands, Poland, Russia, Serbia, Slovakia, Spain, andUkraine.TherehavealsobeenparticipantsfromtheUnitedArabEmirates,Iran,Israel,Pakistan,andtheUnitedStates.Participants have given the course very high marks over the last few years,finding the interactive teachingmethods particularly valuable. They have alsoremarked on the efficient organisation of the course, its usefulness for theireverydaywork, and thewealthofnew informationprovided.Alsoon theplussidearethestudiousatmosphere,roomyconferencerooms,andexcellentfoodanddrink.

ManyofourPainSchoolgraduatesnowplayan important role in thenationalchaptersofEFIC,andbelievethePainSchoolatKlagenfurthashelpedtoinspirethem.WehopethatmanymorecolleaguesinEuropewillgettheopportunitytoparticipateintheEFICPainSchoolatKlagenfurtandexperiencethe“SpiritofPörtschach”.SpecialthanksgotooursecretaryPetraSpendierwhoformanyyearsnowhastakenontheentireresponsibilityoforganisingthePainSchool.

TheEFICPainSchoolatMontescanoDr. Roberto Casale, Foundation “SalvatoreMaugeri“, Department of Clinical,Neurophysiology,PainRehabilitationUnit,Montescano,Italy

From left to right: Prof. Anthony Dickenson, University College, London and member of the TeachingBoard;SchoolDirectorDr.RobertoCasale;Prof.AndreyDanilov,memberoftheTeachingBoard

The EFIC Pain School at Montescano was launched in October 2009 at theMontescano Rehabilitation Institute, a research and care institution.Responsibility for running itwasgiven to the ItalianEFICCouncillorRobertoCasale, a neurologist with a specialisation in anaesthesiology and longexperienceinpainmedicineandtherehabilitationofchronicpainpatients.Theschoolwasajoint initiativeonhispartandonthepartof thenEFICPresidentGiustinoVarrassi.Foundingtheschoolraisedseveralfundamentalquestionsanddiscussionswhichinvolved EFIC Executive Board Members Eli Alon and Nevenka Krčevski

Škvarč,alongwithEFICPast-PresidentSerdarErdineandthenPresident-Elect,Hans G. Kress. The central issue was this: how, at a time when EU healthbudgetswereunderincreasingpressure,couldEFIChelpguaranteethatallEUcitizenswouldreceivethebestavailablediagnosisandtreatment?Theanswerwastoimprovedoctors’diagnosticandtherapeuticskills.Partofthechallenge was the growing number of doctors from different branches ofmedicine involved in diagnosing and treating chronic pain. Other stumblingblockswere the lack of uniformity in the clinical approach to patients and indiagnosis, and linguistic and cultural differences in the European Union. Theright of every European citizen to adequate and equal treatment calls for aminimum common denominator in clinical and therapeutic approaches.Traditionallythetreatmentofpainhasbeenfirmlyinthehandsofanaesthetists.Butrecentyearshaveseenamovebacktoclinicaldiagnosisofpainasanaspectofthenervoussystem.TheEFICPainSchoolMontescanodealswithdifferentaspectsofclinicalandinstrumentaldiagnosis.Specialattentionisdevotedtoclinicalcharacteristicsandpractical demonstrations, in particular to instrumental diagnostic procedures,which doctors, including those without a specialisation in neurology, have tolearnandapplyinclinicalpractice.ThestructureofthePainSchoolencouragesdebateandanexchangeofviewswiththeTeachingBoard.

Classof2009atMontescano

Filling a gap in training opportunities currently offered to young doctors in

Europe,thePainSchoolseeksto-supporttheconceptofpainasadiseaseinitsownright;-improveparticipants’clinicalexaminationskills;- define a core set of diagnostic tools for pain as a disease and familiariseparticipantswithwhatisavailable;-definewhatkindofevaluationshould/couldbedonebythepainspecialist;-establishaflowcharttoevaluatecost/benefit;-promoteaconsistentapproachtotheuseofinstrumentaldiagnosticprocedures;- improve participants’ skills with respect to the planning of instrumentaldiagnosticpathways;-allowparticipantstousealldiagnostictoolsavailable;- help participantswith correctly interpreting the findings of commonly-usedtoolsbyothermedicalspecialities;- allow participants to use some of the most valuable bedside tests in painmedicine.In fulfilling thesecommitments, theMontescanoPainSchoolhas reliedon theexpertise of its TeachingBoard:MarijanaBrass,MariaAdeleGiamberardino,MariaNolano,HansG.Kress,AnthonyDickenson,PerHansson,MagdiHanna,Andrei Danilov, Rudolf Likar, Roberto Caporali, Giuseppe DeBenedittis,ReinhartSittl,MarcoLacerenza,GiorgioSandrini,FrancoMarinangeli,MarcoMatucci-Cerinic, Mauro Zampolini, Carlo Porro. Their specialities includeneurology, neuro- physiology, orthopaedic, physiatry, rheuma-tology, internalmedicine,basicscience,andanaesthesiology.Theyhavedonemagnificentworkinimprovingthequalityofteachinganddeservetobementionedbyname.

Classof2010atMontescano

The current EFIC President Prof. Hans G. Kress takes an innovative andchallengingapproachtosupportingtheEFICPainSchool,nowinitsfifthyear.Participants are encouraged tobeactiveprotagonists and tohelp the school todevelopandimproveon-sitemodelsanddiagnosticpathways.Inrecentyearstheschoolhasbeenattendedbyanannualaverageof20to25doctors.TheyhavehailedfromAlbania,Bulgaria,Croatia,Denmark,Finland,France,Greece,Italy,Kosovo, Lithuania, Portugal, Romania, Russia, Serbia, Turkey, the UK, andUkraine,mostofthemreceivinganEFICgranttoattend.

12. EFIC FELLOWSHIPS AND EDUCATIONALSUPPORTGRANTDespite remarkable progress in pain therapy in the last decade, treatmentstandards vary vastly throughout Europe. Significant disparities can be foundbetween West and East European countries in particular, as well as acrossEastern Europe itself. Since EFIC strongly supports the principle that everyEuropeanshouldbeofferedthesamehighstandardsofpainrelief,avarietyofspecial educational programmes to harmonise those differences are offered toNationalPainSocietiesaswellastoindividuals.

EFICFellowshipsforEasternEuropeanCountriesEFICFellowshipsareindividualgrantsformedicaldoctorstosupporttraininginthe diagnosis, treatment and management of all pain-related problems. The

training takes place for an agreed period of time in an approved centre ofexcellence. The purpose is to allow the trainee to introduce the knowledgeacquiredduringthetrainingintotheireverydaypainpractice.Itisexpectedthatapplicantsareinvolvedinthefieldofpainmedicineorhaveaclearpathwaytospecialisation in painmedicine. Applications are open tomembers of of EastEuropeannationallchaptersofEFIC.EducationalSupportGrantforEasternEuropeanCountriesThis EFIC programme of “bottom up” educational support grants aims atimproving the scope and availability of education for pain clinicians of alldisciplineswithregardtopainanditsmanagementinEasternEurope.Grantsofupto€12.500areallocatedtonationaleducationalprogrammeswhicharedesignedtomeetspecificallyidentifiedneedswithintherespectivecountry.Applications can be submitted by all members of National Pain Societies inEasternEuropeparticipatinginEFIC.

13.THEEFICGRÜNENTHALGRANTTheEFICGrünenthalGrant(E-G-G)aimsatsupportingyoungscientistsearlyintheircareertocarryoutinnovativeclinicalpainresearchinanymembercountryofEFIC.Thegrants–firstawardedin2004andbienniallysince2010–totalupto € 200,000. They are decided independently by the EFIC Committee onResearch. Funding comes from Grünenthal GmbH, a research-orientedpharmaceutical company. The object is to assist young scientists in doinginnovativeclinicalpainresearch.The E-G-G is one of the highest research awards for clinical and humanexperimentalresearchprojectsonthesubjectofpain.Individualresearchgrantsamounttoasmuchas€40,000perproject.Thecriteriaare:- Strength of the applicant - including training, research publication record(relevance,qualityofjournals)andrecommendations.-Noveltyoftheresearchquestion–includingsocietalandscientificimportance.This may include plans to obtain data in support of a future application to amajor granting institution. Hypothesis testing is preferred over empirical datacollection.Exploratoryresearchonparticularly interesting ideas isencouraged,evenifthereisariskoffailure.-Qualityof the researchplan–Theplan should lead to a clear answer to thequestion(s)posed,withinthetimeandbudgetavailable.Projectsthatareoverly

ambitiousmustbeavoided.

EGG2012Nociceptive nerve endings as a target for autoantibodies.: Jordi Casanova-Molla,MD,PhDVisuospatial adaptation with prisms in strokerelated complex regional painsyndrome:actingonpainorneglect?:SamarHatem,MD,PhDA longitudinal studyonchronicpain, anxietyanddepression:LannieLigthart,PhDFear generalisation as a pathway to chronic widespread pain: AnnMeulders,PhDImaginggreyandwhitematterpathologyincentralpost-strokepainwithMRI:TillSprenger,MD“Pain engrams”: psycho-physiologic investigations of memory traces ofnociceptiveinformation:EliaValentini,PhDDefining peripheral and central pathophysiology and heritable susceptibilityfactorsofciguatera-associatedcoldallodynia:KatharinaZimmermann,MD

EGG2010Modulation of central cerebral pain processing by transcranial direct currentstimulation(tDCS)usingultra-highfieldfunctionalmagneticresonanceimaging(fMRI)at7Tesla:DagnyHolle,MDThecontributionofaxonalsensitisationtopainandhyperalgesia.NGF-inducedchangesofsignaltransformationinhumanC-fibers:BarbaraNamer,MDExaminingthefunctionalroleofKv7sub-typesingastrointestinalpainusinganovelhumanpre-clinicalmodel:MadushaPeiris,PhDGenome-wide association studyof pressurepain threshold– a step forward touncoveringgenesunderlyingpainsensation:OzrenPolasek,MD,PhDLinking altered central pain processing and genetic polymorphism to drugefficacyinchroniclowbackpain:AndreasSiegenthaler,MDPainsensoryprofilesindiabeticperipheralneuropathicpain:StefanoTamburin,MD,PhDCerebral neuronal activity in pain-related brain areas of patients withfibromyalgia syndrome and interleukin-4 deficiency using near-infra-red

spectroscopy:NurcanÜçeyler,MDPain sensitivity of children with Down’s syndrome: Is it really different?:AbrahamValkenburg,MSc

EGG2009Oxytocinandtheplaceboeffect:LuanaColloca,MD,PhDCutaneousneuroimmuneinteractionsinthegenesisofchronicneuropathicpain:ElspethHutton,MD,FRACP,MBBS(Hons),BMedSci(HonsHons)Measuringpaininthehumaninfantbrain:RebeccahSlater,PhDPain demands the attention of others: parental detection, interpretation andresponsestotheirchild’spain:TineVervoort,PhDRoleofnociceptiveafferentsinneuropathicpain:GunnarWasner,MD

EGG2008TheassociationofCOMTpolymorphismswithchroniclowbackpainincombatrelatedPTSD:MarijanaBras,MD,PhDResponseofthebraintonon-painfulsomato-sensorystimulibeforeandaftertheinduction of nociceptive long-term potentiation: An EEG study in healthysubjects:EmanuelvandenBroeke,MScRoleofthepainmodulatingDREAMpathwaygenesinchronicmusculoskeletalpain:KateLimer,PhDSteady-state evoked potentials to explore the cortical processes underlying theperceptionofpain:AndréMouraux,MD,PhDDetermining optimal drug regimen in individual patients with chronic pain:GorazdSveticic,MD

EGG2007Referredpain related to ‘memory’ in thenociceptive system:ThomasGraven-Nielsen,PhD,DMScBehavioural and neurophysiological explorations of cognitive modulations ofpain:ValéryLegrain,PhDComprehensivegeneticanalysisof thecalcitoningene-related-peptidepathwayinmigrainewithaura:ChristianNetzer,MDGammaoscillationsandhumanpainperception:MarkusPloner,MD

Functional imaging of sympathetic arousal in fibromyalgia: Dieuwke S.Veldhuijzen,PhD

EGG2006Imaging how pain interferes with information processing in other modalities:UlrikeBingel,MDFacingtheirchild’spain:theimportanceofparentalempathy:LiesbetGoubert,PhDFunctional imaging of C-fibre-induced plasticity within the human brain:ChristianMaihöfner,MD,PhDErythermalgiaasamodeldiseasetoassesscontributionofNav1.7tosmallnervefibrefunctionandpain:CarlaNau,MDInterhemispheric inhibition in patients with complex regional pain syndrometypeI:DrPhilipKrause,MD

EGG2005Long-termdepressionofhumanpainprocessing:Prof.JensEllrich,MD,PhDCansomaticallodyniabeusedasabiomarkerofcentralsensitisationinahumanmodelofvisceralinjury?:AnthonyR.Hobson,PhDPsychologicalinterventioninchronicwhiplashsyndrome.Aplacebocontrolledrandomisedstudy:HelgeKasch,MD,PhDHigh resolution fMRI of anti- and pro- nociceptive processing in the humanbrain stem of patients with IBS and FM: Irene Tracey,MA, PhD, ChristinaLiossi,PhD,CPsychol

EGG2004Theroleof self-discrepancies (discrepanciesbetween theactual selfandeithertheidealselfor the‘ought’self) inpatientswithchronicpain:JeffreyRoelofs,PhDModulation of pain perception in uninjured and injured tissue in humanvolunteers:EstherPogatzki-Zahn,MDMRIstudyon theaffectivemodulationofpainprocessing in thehumanbrain:RonKupers,PhDGenetic and environmental influences on pain sensitivity and regulation.Psychological and pharmacological mechanisms: Prof. Audun Stubhaug,MD,

PhDAttentiontopaininthecrossmodalconstructionofspace:StefaanVanDamme,PhDNeurophysiologyofpainperceptioninthehumanbrain:MaudGaëlleFrot,PhDInteraction between the endogenous opioid system in the brain and cognitivemodulationofpain:PredragPetrovic,MD,PhD

14.IMPORTANTDOCUMENTSEFICDeclaration on pain as amajor health problem, adiseaseinitsownright(2001)Pain is a major healthcare problem in Europe. Although acute pain mayreasonablybeconsideredasymptomofdiseaseorinjury,chronicandrecurrentpainisaspecifichealthcareproblem,adiseaseinitsownright.Acute pain, such as that following traumaor surgery, constitutes a signal to aconscious brain about the presence of noxious stimuli and/or ongoing tissuedamage.Thisacutepainsignalisusefulandadaptive,warningtheindividualofdangerandtheneedtoescapeorseekhelp.Acutepainisadirectoutcomeofthenoxious event, and is reasonably classified as a symptomof underlying tissuedamage or disease. However, in many patients pain persists long after itsusefulnessasanalarmsignalhaspassed,andindeed,oftenlongafterthetissuedamagehashealed.Chronicpaininthesepatientsisprobablynotdirectlyrelatedto their initial injury or disease condition, but rather to secondary changesincludingonesthatoccurinthepaindetectionsystemitself.Inadditiontobeingduetodifferentphysiologicalmechanismsthanacutepain,chronicpainoftensetsthestagefortheemergenceofacomplexsetofphysicalandpsychosocialchanges thatarean integralpartof thechronicpainproblemandthataddgreatlytotheburdenofthepainpatient.Theseinclude:-Immobilityandconsequentwastingofmuscle,jointsetc.-Depressionoftheimmunesystemandincreasedsusceptibilitytodisease-Disturbedsleep-Poorappetiteandnutrition-Dependenceonmedication-Over-dependenceonfamilyandothercaregivers

-Overuseandinappropriateuseofprofessionalhealthcaresystems-Poorperformanceonthejoborinabilitytowork,disability-Isolationfromsocietyandfamily,turninginwards-Anxiety,fear-Bitterness,frustration,depression,suicide

PrevalenceofchronicpainAlthoughcomprehensive epidemiological data for theEuropeanUnion arenotavailable, chronic pain is clearly a very widespread condition. Several recentcommunity-basedsurveys,forexample,foundthatabout50%ofadultssampledsuffered from one or more types of pain at any given point in time. In asubstantialproportionofthosesurveyed,thepainwasbothchronicandsevere--thenumbersincreasingconsiderablyinolderagegroups.Themostwidespreadchronic pain conditions, low back pain, arthritis and recurrent headache(includingmigraine) are so common that they are often seen as a normal andunavoidablepartoflife.Althoughfewpeopledieofpain,manydieinpain,andevenmoreliveinpain.

SocialcostsofchronicpainWhileacutepainisbydefinitionabriefandself-limitingprocess,chronicpaincomes to dominate the life and concerns of the patient, and often also family,friendsandothercaregivers.Inadditiontothesevereerosioninqualityoflifeofthepainsuffererandthosearoundhim/her,chronicpainimposesseverefinancialburdensonmanylevels.Theseinclude:-Costsofhealthcareservicesandmedication-Jobabsenteeismanddisruptionintheworkplace-Lossofincome-Non-productivityintheeconomyandinthehome-Financialburdenonfamily,friendsandemployers-WorkercompensationcostsandwelfarepaymentsAuthoritativesourcesplacetheoveralfinancialcostsofchronicpaintosocietyin the same range as cancer and cardiovascular disease.Themagnitude of thechronicpainepidemicintermsofhumansufferingandcoststosocietyarewellknowninthefieldofPainMedicine.However,theyarenotwidelyappreciatedwithinthelargerbiomedicalcommunity,amongmakersofsocialpolicyandin

thepublicatlarge.Bycallingattentiontothisproblem,theEuropeanParliamentwillbenefitthelargepopulationofchronicpainsufferersinEuropeby:- Increasing the attention devoted to the problem by healthcare professions,including increased awareness and use of existing pain relief modalities,increased training in the management of chronic pain and research effortstowardsthediscoveryofnoveltreatments.-Facilitating efforts bypainprofessionals at thenational level to recruitmorehumanandfinancialresourcesinthebattleagainstchronicpain.TheEFICDeclaration2001waslaunchedattheEuropeanParliament.

EFIC-IASP Declaration: The relief of pain should be ahumanright–Acallforaction(2004)1.Calluponallcountriestoimprovereliefofallformsofpainaspartofafocuson human rights, and to permit optimal quality of life and productivity ofcitizens2. Call upon all countries to include a right to pain relief as part of theirconstitutions3. Call upon all countries to evaluate the current disease burden of persistent(chronic) pain in terms of prevalence, impact on individuals, families andcommunitiesandfinancialcosts4.Calluponallcountriestoenactnationaland/orregionalstatutoryrequirementsfor undergraduate and continued education about pain relief for all healthprofessionals5.EncourageWHOtosupportinitiativeswiththeUNtodeclare“PainReliefasaUniversalHumanRight”6. EncourageWHO to continue to pursue programs such as: deregulation ofopioidavailability;provisionofaffordableopioidsworldwide;fosteringnationalpaineducationandtreatmentprograms(likeJCAHO,USA);fosteringadvocacyprogramssuchasthe“GlobalDayAgainstPain”;lobbyingtheUNtodeclarean“InternationalYearofPainRelief”7.Supportpublicadvocacygroupstofocusonrightstopainreliefinparticularsituations such as: pain in children; pain in theolder agegroup; pain in thosewithcommunicationdifficulties;cancerpain;paininHIV/AIDS.

The Societal Impact of Pain - A RoadMap for Action

(2011)WecallonEuropeangovernmentsandtheEUInstitutionsto:1.Acknowledgethatpainisanimportantfactorlimitingthequalityoflifeandshouldbeputonthetopoftheprioritylistofthenationalhealthcaresystem.2. Activate patients, their family, relatives and care-givers through theavailabilityofinformationandaccesstopaindiagnosisandmanagement.3.Raiseawarenessofthemedical,financialandsocialimpactthatpainanditsmanagement has on the patients, their family, care-givers, employers, and thehealthcaresystem.4.Raiseawarenessoftheimportanceofprevention,diagnosisandmanagementofpainamongstallhealthcareprofessionals,notablythroughfurthereducation.5.Strengthenpainresearch(basicscience,clinical,epidemiological)asapriorityinEUframeworkprogrammeand inequivalent researchroadmapsatnationalandEUlevel,addressingthesocietal impactofpainandtheburdenofchronicpainonthehealth,social,andemploymentsectors.6.EstablishanEUplatformfortheexchange,comparisonandbenchmarkingofbest practices betweenmember states on painmanagement and its impact onsociety.7. Use the EU platform tomonitor trends in painmanagement, services, andoutcomes and provide guidelines to harmonize effective levels of painmanagementtoimprovethequalityoflifeofEuropeanCitizens.

EFIC-WIP-WIPF-WSPCDeclarationofMiami-Itistherightofanyhumanindividualtohaveaccesstothebestpossiblepainreliefinanyandeverypartoftheworld.-We, as a consortium of professional pain societies, and aswitnessed by therepresentatives from all continents, affirm the above declaration and strivetowardsitsfulfillment.-Theadvancesinmedicinewillcontinuetoincreasethepopulationofhealthy,youngandoldpeopleallovertheworld.- Presently, there is still limited access to adequate treatment of acute andchronicpaininmanypartsoftheworld-Governments and even healthcare professionals are not sufficiently aware ofchronicpainasahealthproblem.

-Manyhealthcareprofessionalsarenoteducatedandfamiliarwithbestpracticepainmedicine.-We demand that PainMedicine should be a distinct specialty because of itsuniquebodyofknowledgerequiredtotreatpainpatients.-Thedeclaringprofessionalorganizations jointlyandfirmlyagreeon therightofanyhumanindividualtohaveeasyaccesstoadequatepainmanagement,thenecessityofgenerallyavailableinformationaboutproperoptionsforpainreliefand the obligations of governments and health systems to provide financial,personnel and structural resources to achieve these goals and to guaranteeadequatepainmanagementasahumanright.With this Declaration of Miami on February 5, 2012, the signatories of theconsortium affirm that they will expeditiously and diligently work towardsaccomplishingthegoalsofthedeclaration.Thepainsocietiesactivelypromotebestpainmedicineforallhumanity;andarededicatedtoprovidingtrainedandskilledpersonnelintheirspheresofinfluence.In this regard, theWorld Institute of Pain, the European Federation of IASPChapters,theWorldInstituteofPainFoundation,andtheWorldSocietyofPainClinicianscometogethertopromotethismission.Dr.RicardoRuiz-Lopez,PresidentofWIP,Prof.HansKress,PresidentofEFIC,Prof.RobertvanSeventer,PresidentofWSPC,Prof.PrithviRaj,Chairman,WIPFoundation,Prof.SerdarErdine,CEO,WIPFoundation

PhotocreditsEFICarchivesRobertoCasaleSerdarErdineKathleenGirardGrünenthalBettinaHaake-WeberHermannO.HandwerkerJürgenHammerschmidKenesHansG.KressRudolfLikarThierryMonasseIsabellePateer/OtherweyesReimoSchaafFotografieReinhardSittlPeterVogel

ImprintEditors:Prof.SerdarErdine,Prof.HansG.Kress©EuropeanPainFederation(EFIC®),Brussels,2013,2017Publisher:B&K–Bettschart&KoflerKommunikationsberatungGmbH,A-1090Vienna,Liechtensteinstraße46a,AustriaEditorialteam:Bettschart&KoflerKommunikationsberatung–Dr.BirgitKoflerCoverdesign:PatricioHandl,ViennaISBNoftheeBook2017:978-3-200-05244-4ISBNoftheprintversion2013:978-3-200-03234-7

TableofContents1.EDITORIAL2.EFICATAGLANCE

AimsConstitutionEFICOffice

3.EFICEXECUTIVEBOARDS1993-20141993-19961996-19991999-20022002-20052005-20082008-20112011-2014

4.EFICNATIONALCHAPTERSAlbaniaAustriaBelgiumBosniaandHerzegovinaBulgariaCroatiaCzechRepublicDenmarkEstoniaFinlandFranceGermanyGreeceHungaryIrelandIsraelItalyKosovoLatviaLithuaniaMoldova

NorwayPolandPortugalRomaniaRussiaSanMarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandTheNetherlandsTurkeyUkraineUnitedKingdom

5.MILESTONESINTHEHISTORYOFEFIC1993199519961997199920002001200220032004200520062007200820092010201120122013

6.EFICPRESIDENTS1993–2014“Itoccurredtomeitwouldbeagoodthing...”“SpreadingthewordinEuropeaboutbettertreatmentforpain.”

“One in fiveEuropeans is inpain.Theyhavea fundamental right totreatment.”“EFIC:Animportantleapforwardinthescienceofpain.”“IhadthegreatopportunitytowitnesshowEFICgrewandbecameawell-respectedinternationalpainsociety.”“An important contribution EFIC can make is to increase therecognitionofpainpatients’needs.”“Working on better pain relief and fighting for our chronic painpatients.”

7.THEEUROPEANJOURNALOFPAINTheearlyyearsMovingonfrompaperworktointernet

8.THEEUROPEANWEEKAGAINSTPAIN20012002200320042005200620072008200920102011

9.THEEUROPEANYEARAGAINSTPAIN10.SOCIETALIMPACTOFPAIN(SIP)

SIP2010SIP2011SIP2012SIP2013

11.THEEFICPAINSCHOOLSTheEFICPainSchoolKlagenfurt-Pörtschach

GenesisoftheEFICPainSchoolideaFormatandcontent

TheEFICPainSchoolatMontescano12.EFICFELLOWSHIPSANDEDUCATIONALSUPPORTGRANT

EFICFellowshipsforEasternEuropeanCountries13.THEEFICGRÜNENTHALGRANT

EGG2012

EGG2010EGG2009EGG2008EGG2007EGG2006EGG2005EGG2004

14.IMPORTANTDOCUMENTSEFICDeclarationonpainasamajorhealthproblem,adisease in itsownright(2001)

PrevalenceofchronicpainSocialcostsofchronicpain

EFIC-IASPDeclaration:Thereliefofpainshouldbeahumanright–Acallforaction(2004)TheSocietalImpactofPain-ARoadMapforAction(2011)EFIC-WIP-WIPF-WSPCDeclarationofMiami

PhotocreditsImprint