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.
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.
Note: Die development of a pain memory is a completely normal biological process whereby some people are more likely to be affected then others. It is definitely not a sign of oversensibility.
If you are concerned with chronic pain you may find the term „multimodal therapy“. It means nothing else then that there is not one single form of therapy but an abundance of different methods. The task of the physician is it to find out the best suiting for the individual patient.
It is very important for us to talk about every single step of the planned treatment and to involve the patient. Therefor we need time. If there is the suspicion of chronic pain we will directly speak to you. The most important thing for many patients is that the chronic pain is a disease and the patient himself is not responsible for it. If you want to you can have a look in the web and search for “chronic pain” or “chronic pain syndrome”.
Afterwards we will initiate further consultations and a questionnaire. The chronic pain syndrome is very complex and sometimes hard to understand.
It is important to understand, that the chronic pain is not a psychiatric disease even if the psyche is an important part of it. The modern pain therapy does not differentiate between body and the psych but tries to see it as a joint unit.
Sometimes the psychosocial factor can be more important than the physical factors. Today pain can be seen as a bio- psycho- social disease.
We will evaluate the character of the pain together with you and create an individual therapy plan. In some cases a single drug is not enough and needs to be combined with others.
According to the guidelines of the specialist society we will start with a low dosed antidepressant agent. The dose we are using for pain treatment is way lower than the dose patients get as real antidepressant. Therefor it does not have an antidepressive effect. The drug influences the pain sensation in the brain