Background: Chronic pain is a frequent and undertreated ailment within the long-term care community (Herman et al, 2009). The likelihood of experiencing pain increases with age and failure to treat this condition may expose individuals to prolonged and unnecessary suffering (Ramage-Morin, 2008). Furthermore, undertreated pain can lead to a life of inactivity and a failure to carry out normal social and vocational roles which in term may result in higher rates of depression, anxiety and sleep disorders (Clark, 2000). The present study aimed to explore staff perceptions on current pain management within long-term care including insights to future needs in optimizing pain management. This work will contribute to the overall awareness surrounding possible reasons that current pain management within long-term care is viewed as suboptimal (Herman et al, 2009). Methods: A qualitative, post-positivist grounded theory study was carried out in order to investigate staff-perceived strengths, weaknesses and barriers surrounding the topic of pain-management within the long-term care setting. Semi-structured interviews with 17 long-term care staff members from a variety of vocations were conducted with a focus on identifying and clarifying properties surrounding the notion that pain management is currently suboptimal. A focus group session was implemented as a method to further develop the emerging grounded theory. Results: Nine themes surrounding pain management within the long-term care setting were identified in the present study. These themes gave rise to the core concept of creating an environment supportive of optimal pain management. The nine themes were integrated into the theory of optimization of pain management within long-term care through thematic interpretation. The focus group session further developed and confirmed themes identified throughout the one-on-one interviews as well as expanded the discussed theory. Discussion: The developed theory of optimization of pain management within the long-term care setting provides a comprehensive overview of the current barriers facing adequate pain management as well as outlines future suggestions for improvement of managing pain within the long-term care setting.