This chapter discusses the physiology and management of pain in general, with particular attention to chronic pain and various neurosurgical interventions. Chronic pain may be defined as pain without apparent biological value that has persisted beyond normal tissue healing time (usually taken to be 3 months). Elucidation of the causes and types of pain a patient presents with is crucial; mechanism-based pain treatment is most likely to be successful. Specific interventional treatments, such as, trigger point injections, sacroiliac injections, nerve root injections, facet-joint injections, lumbar and caudal epidurals are well known to the neurosurgeons. Stimulation at various levels in the pain pathway (TENS, SCS) is the next step. DBS is increasingly used of late. Ablative procedures are rarely done; they may help in cancer pain.