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Chronic pain: causes, treatment, self-help

by Josephine Andrews
Published: Last Updated on 360 views

Chronic pain affects the quality of life of countless people. The ordeal of those affected often begins with acute pain due to an injury or illness. Over time, they develop into chronic pain, which persists even after the causal tissue damage has healed – the pain has become a disease in its own right. Read more about how chronic pain develops and how it can be treated here.

Chronic pain: description

Chronic pain is pain that has almost always been present for at least three to six months or that recurs frequently and impairs the patient physically (loss of mobility, functional impairment), physical-cognitive (sensitivity, mood, thinking) and socially . The pain is the predominant symptom (“main symptom”) of the complaints.

In contrast to acute pain, chronic pain (medically correct: chronic pain syndrome ) is no longer a sensible alarm signal that indicates damage to the body (injury, illness, etc.). Instead, they represent an independent pain disorder that often no longer has a clearly identifiable cause.

Chronic pain is often accompanied by other symptoms, such as sleep disorders , lack of appetite , increased irritability and depressive moods. In addition, they can mean severe restrictions in everyday life, work and leisure time.

chronification

A chronic pain syndrome often arises from acute symptoms: Persistent pain stimuli cause the nerve cells to react more and more sensitively to the stimuli over time, i.e. the pain threshold drops. The repeated pain stimuli leave behind “pain marks” and a “ pain memory ” develops. Patients perceive even the slightest pain stimulus or even touch as pain. The nerve cells can even send pain signals to the central nervous system of their own accord, even though the original cause of the pain (eg an injury) has long since healed. So it hurts, although there is no longer any organic cause for it.

Risk factors for chronic pain

Chronic pain syndrome can be favored by numerous factors. These include:

  • Persistent psycho-vegetative tension (someone is constantly “live”)
  • History of anxiety and depression
  • prolonged stress or pain experiences in the past life history
  • relatives in the family who are suffering from pain
  • Tendency to “catastrophe thinking” – someone always imagines the worst possible consequences
  • constant ignoring of stress limits, constant perseverance
  • Fear-Avoidance Belief (avoids exercise and physical activity for fear of increased pain)
  • inadequate pain management when the pain started
  • no talking about the pain
  • family conflicts
  • social problems in the environment (e.g. at work) or financial difficulties
  • Advantages arising from the illness (e.g. early retirement)

Chronic pain: causes and possible diseases

Chronic pain can be divided into three categories:

Chronic pain as an accompanying symptom of a physical disorder: This includes, on the one hand, “normal pain” that accompanies a physical disease (such as rheumatism, arthrosis , osteoporosis ) or nerve damage. On the other hand, this category includes “extraordinary pain”, such as phantom pain after an amputation . Complaints related to complex regional pain syndrome (CRPS) are also included. This is defined as persistent, regional pain that is disproportionately long and intense. It is disproportionate to the triggering trauma (such as nerve damage) and cannot be explained by other causes.

Physically partially explainable pain with psychological comorbidities (comorbidity): This includes chronic pain caused by tissue damage that is aggravated by psychological factors. One example is back pain that radiates into the leg and is caused by a herniated disc in the lumbar spine ( lumboischialgia ). They can be made worse by, for example, insufficient coping with the illness, an anxiety disorder or a depressive disorder.

Chronic pain as an expression of a primarily mental illness: Chronic pain occurs primarily in connection with depressive disorders, but also with anxiety disorders, post-traumatic stress disorder or other mental illnesses.

Chronic forms of pain
The most common forms of pain that can take a chronic course include:

  • Headaches such as chronic migraines , chronic tension headaches
  • Back pain like chronic low back pain
  • Muscle pain as in fibromyalgia (chronic pain disorder that affects not only the muscles but also the tendons and joints in particular)
  • Joint pain as in arthrosis, rheumatoid arthritis
  • tumor pain

Chronic Pain: When Should You See a Doctor?

Be sure to see a doctor if:

  • You have persistent or recurring pain of unknown origin
  • the pain keeps getting worse
  • the pain is accompanied by other symptoms, for example chronic back pain with numbness in the legs or chronic headache with impaired consciousness
  • Your everyday life and quality of life are affected by chronic pain

Chronic pain: what does the doctor do?

First, the doctor will have a detailed discussion with you about your medical history ( anamnesis ). The focus is on the following questions:

  • How long have you had chronic pain?
  • Where are they performing?
  • How does the chronic pain feel (pain character)?
  • How bad is the pain?
  • Are they triggered, intensified or alleviated by factors such as exercise, cold, heat, stress etc.?

You should also provide information about pain-related impairments in everyday life, any other complaints (such as sleep disorders , digestive problems, etc.), previous and current illnesses, operations and previous therapies against the pain.

Psychosocial information is also important for the doctor, for example information on training and occupation, job situation, satisfaction, family status and any current conflicts and stresses.

This is followed by a thorough physical examination . Depending on the type of chronic pain (e.g. headache, back pain) and information from the conversation, further examinations may follow. These include, for example, neurological, orthopedic or internal examinations. If necessary, imaging methods are also used, such as ultrasound , X -rays , computed tomography or magnetic resonance imaging. Blood tests and electrophysiology tests (such as measuring nerve conduction velocity) can also sometimes help.

Chronic pain: therapy in conventional medicine

Chronic pain is treated in a variety of ways, depending on the type and intensity of the pain. For example, pain medication, physical therapies (such as massage, water applications, cold and heat treatments), movement therapy (such as physiotherapy, sports), acupuncture and nerve stimulation ( TENS ) and psychological therapies are used to relieve chronic pain.

Chronic pain: you can do it yourself

You can also do a lot yourself against chronic pain:

  • Relaxation techniques : Chronic pain usually means permanent stress for those affected, coupled with fear, frustration, desperation and depressive moods. Such negative emotions increase the pain. Relaxation techniques help to break this vicious circle. For example , autogenic training , biofeedback , meditation, yoga, progressive muscle relaxation and mindfulness training are suitable. They influence pain perception, support pain management and stimulate the body’s self-healing powers.
  • Complementary therapies : In addition to acupuncture, other complementary therapies such as acupressure, osteopathy, magnet therapy and reflex therapies can also relieve chronic pain. Check with an experienced therapist.
  • Schuessler salts : Schuessler salts are also part of the complementary procedures and can be tried in the event of symptoms. For example, the Schüßler salts No. 9 sodium phosphoricum , No. 11 Silicea , No. 1 Calcium fluoratum and No. 2 Calcium phosphoricum are recommended for chronic pain in the back area. The pills are taken in ascending order, so first #9 for about a week, then an additional #11, and so on. Dissolve each tablet in your mouth . For minor pain, take the tablets once a day; in the case of severe chronic pain , it can be taken up to ten times a day.

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