Key Messagesr Patients often have poor understanding regarding pain management, which results in low expectations of pain relief and satisfaction with inadequate pain control.r The experience of pain has long been accepted as an inevitable part of surgical intervention, but new understanding reveals a dynamic and complex nervous system which can change in response to unrelieved pain, potentially leaving permanent damage and chronic pain.r Health care professionals often lack appropriate knowledge, attitudes and skills to effectively manage pain due to inadequate education.r Local hospital regulations and policies may inadvertently inhibit the effective management of pain by causing unnecessary delays to the timely administration of analgesics.r Globally, many people are denied good pain relief due to some countries' inability to effectively import and distribute morphine for medical reasons.