In the mid-1940s, John Bonica (1917–1994) worked as an anesthesiologist at Madigan Army
Hospital in Tacoma, Washington, where he found that nerve blocks with local anesthesia were
simply not enough to effectively treat intractable pain. Bonica began to refer patients whose pain
baffled him to an orthopedist and a neurosurgeon, as well as a psychiatrist, because stress and
depression often accompany chronic pain. Bonica proposed that the four specialists meet twice a
week to review information on difficult pain cases; this collaborative, interdisciplinary approach to
pain care was new and quickly became the gold standard in the field. By the late 1980s, close to
2,000 pain clinics had been established in 36 countries around the world, and pain clinics are now
commonplace. In most pain clinics, physical therapists provide traditional pain therapies as well as
exercise, manual therapy, and functional training. Some pain clinics also offer complementary
medicine modalities so that patients may take advantage of the full spectrum of available pain
therapies in order to find the combination that best eases their pain.