Long standing pain is one of the main indications for elective orthopaedic surgery such as hip replacement, knee replacement and spine surgery, but many patients still report pain long time after surgery. Both physiological and psychological factors (depression, fear of movement and catastrophic thoughts) may interact in such situations. The duration of preoperative pain and social factors also affect the risk for remaining pain after the operation. By evaluating the patients’ sensitivity for pain and assessing psychological risk factors using validated assessment tools before surgery, it should be possible to improve the surgical result regarding postoperative pain and function.