chronical pain

chronic pain

Definition: Pain can be seen as a complex sensual perception which has the function of a warning a leading signal under acute circumstances. A chronic pain is an acute pain which lost its original function and can be seen as an individual disease or syndrome.

Many patients ask if it is really possible that all they are suffering from has a single psychic origin. “I do not only surmise the pain!” Why do we have to suffer from pain which has no real causing agent?

During the past years we got a lot of experience with pain patients so we prefer another definition of pain: Pain is what the patient experiences as pain. Pain is always subjective!

A chronic pain can be seen as a pain which lasts for a longer period of time (around 3- 12 month). Longer lasting pain can develop to a pain syndrome which is an individual disease or pain syndrome. The pain has lost its original function and is characterized by its organic discomfort as well as the psychosocial changes which result out of the pain.In most of the cases a chronic pain has not a single but multiple causes.

Pain memory

Schmerzen ausradieren?

Schmerzen ausradieren?

Delete pain?

Nerve cells can learn. When we try to learn a poem by heart we have to repeat it several times. If we suffer from pain our brain uses the same learning procedure.

Acute pain is necessary for our survival because they prevent us from a greater damage. If the pain occours several time our brain will focus on this pain which leads to a decreased pain threshold in this specific area. The pain signals will be transmitted more likely in comparison to other impulses.

During time the (organic) origin of the pain may be removed but our brain still perceives the pain. Similar to an ear worm the pain got stuck in our brain. This could cause normal contact to be painful. We can compare the system with a defect booster.

Neurological changes include

Changes of the neuronal network

Biochemical changes in the nerve cells and the synapses

Adaption to the pain sensors.

Emotional pain?

Emotional pain?

In nearly all every days tasks we are very proud of what our brain is able to manage. Only if it comes to pain we aren’t even if the pain is an active carry out of our brain as well.

I would say it always comes down to both: The body and the brain (psyche) It is pointless to differentiate between both of them.

Pain which does not have a touchable reason is one of the most nasty things we can experience.

Why has evolution allowed for something like "pain for no reason"?

Are "pain without cause" meaningless?

Einsamkeit

Einsamkeit

Loneliness:

The connection between pain and loneliness can be explained if we have a closer look at the evolution. Scientists from the Uiversity of Califronia in Los Angeles made an interesting discovery. If someone feels unloved or lonely this could have an similar impact on the human as physical pain. Social aspects and physic suffering overlap.

With the help of MR imaging they had an inview on metabolically active areas in the brain. A test person needed to play a ball game with video glasses and a joystick. The game started with to other players. After some time the two other players started to exclude the test person by not throwing the ball to him anymore. During this the same brain area showed activity like in pain patients: the anterior gyrus cingula. Meanwhile we know that this area is responsible for the pain intensity no matter if it is physical or emotional.

With the help of MR imaging they had an inview on metabolically active areas in the brain. A test person needed to play a ball game with video glasses and a joystick. The game started with to other players. After some time the two other players started to exclude the test person by not throwing the ball to him anymore. During this the same brain area showed activity like in pain patients: the anterior gyrus cingula. Meanwhile we know that this area is responsible for the pain intensity no matter if it is physical or emotional.

Pain and its attention, Tinnitus

ain and its attention, Tinnitus

Pain and its attention, Tinnitus

The body automatically pays its attention to the painful body part. At the area where the pain does come from is something not in the right order which means that the brain has to pay its full attention to the particular area.

The adaption of the neuronal network is as more effective as more attention the brain affords for the stimulation. One good example for this is a tinnitus. It does not really have an organic origin and easy trigger can be a night out at a night club which causes abnormal sounds in the ear. This sounds will get louder and louder as more attention we pay to them.

Therefore we can treat either a tinnitus or chronic pain if we try to divert the attention. Both can be seen as misguided learning procedures in the neuronal network of the brain.

Around 11 million people over 18 years in Germany do suffer from some sort of chronic pain.

The origin for this can be diverse. The most common are: rheumatic diseases, chronic Polyarthritis, Morbus Bechterew, Pain which radiates from the connective tissue like Fibromyalgia or myopathia, chronic headache, phantom pain after an injury of the extremities, amputations, carpal tunnel syndrome, sulcus ulnaris, nerve tumors, nerve injuries, scars after operations, inflammations…

Our main aim is to optimize the pain therapy for our patients. Therefor we try to get an exact overview of the disease of every single patient. We have to figure out which treatments have been applied already, if they were successful in a certain point, if it useful to offer a neurosurgical treatment or if it would be more useful to consult another specialist. For the treatment of chronic pain patients we are in close contact and exchange with other colleges of orthopaedic, neurologic, anaesthetic or psychologic specialization. All of us participate in an interdisciplinary pain conference where we can present your case. You will get acces to the opinion of many specialists in a short priod of time.