The Pain Clinic at the University of Virginia Medical Center is a comprehensive facility providing a coordinated team approach to the management of chronic pain syndromes. The Clinic is primarily an out-patient facility, although in-patient therapy in clinic-assigned beds is available for special problems. Approximately 1,500 new patients are seen annually in the Clinic's own facilities, resulting in approximately 3,500 patient visits. All diagnostic facilities are readily available, and all somatic modulation and psychotherapeutic techniques are utilized for pain management. Referrals are accepted only from physicians and then only after all medical records, the Clinic's Patient Assignment Inventory Narrative (a screening brochure), and special studies are reviewed. The initial evaluation includes, as well, history taking, physical examination, psychological testing and interview, special studies, specialty consultations, and family interview. A therapeutic plan is then developed and discussed with the patient and family members. The Clinic's philosophy is to encourage the patient to assume responsibility for all aspects of the treatment program including drug detoxification, activity and exercise programs, and functional performance.