Chronic pain

When the pain keeps coming back

In medicine, a distinction is made between acute and chronic pain.
Acute pain is pain that can be traced back to a specific trigger, such as a bee sting or a cut.
It has a warning function and protects the person from further injury.
Once the illness or wound has healed, the pain subsides.
Chronic pain, on the other hand, is no longer a side effect of specific illnesses, but occurs independently of them.
If acute pain is not treated, recurs or lasts longer, this can lead to chronic pain.

This can also lead to changes in the nerve cells that trigger pain even if there is no longer an immediate cause.
Doctors refer to this as “pain memory”.
Detached from the original stimulus, chronic pain itself becomes a disease.
Examples of diseases that can lead to chronic pain include back problems, rheumatism, diabetes mellitus, arthrosis and arthritis.

Symptoms of chronic pain

People with chronic pain often experience fatigue, sleep or eating disorders, which can develop into anxiety and depression.
Those affected may limit their leisure activities, withdraw, lose weight and lose interest in their environment.
Many different parts of the body can be affected by chronic pain.
Pain is considered chronic if it

last longer than three months
are still noticeable one month after an injury or illness has healed
occur repeatedly over months or even years
are associated with a chronic illness or injury that does not heal

Causes of chronic pain

Some chronic pain is clearly attributable to a trigger, for example in the case of osteoarthritis or arthritis.
However, chronic pain often develops over a longer period of time, becomes more severe and spreads throughout the body.
It is then often difficult to determine the cause.
Chronic pain can essentially be divided into the following categories:

Nociceptive pain: This is pain that is triggered by an injury or disorder in the organs or tissue.
Bone fractures, colic or a heart attack are examples of this.
Pain receptors, known as nociceptors, send out the pain signals.
Depending on the cause, this can result in burning, stabbing or throbbing pain.
If organs are affected, the pain can also be dull or cramp-like.

Neuropathic pain: This type of pain is the result of irritation and damage to nerve fibers, for example as a result of injuries, shingles or diabetes, metabolic disorders or alcohol abuse.
It can occur abruptly and in attacks, but can also be accompanied by tingling, numbness and hypersensitivity.

Pain due to inflammation: Infections and other inflammatory processes in the immune system can also trigger pain.
In some diseases, the immune system also targets the body’s own cells, which means that persistent inflammation can cause chronic pain, such as in the case of rheumatoid arthritis.

Pain due to altered pain processing: Disturbed pain processing in the brain can be another cause of chronic pain.
Examples of this type are irritable bowel syndrome or chronic cystitis.

Treatment & Therapy

In the case of chronic pain, the main aim is to learn how to manage it and reduce its intensity so that sufferers can enjoy as high a quality of life as possible despite recurring impairments. Here it is important to respond individually to the person and the respective pain. For this reason, therapy is usually based on different components from several disciplines. In addition to drug treatment, a combination of exercise and relaxation can help, integrating remedial gymnastics and physical therapy forms, as well as relaxation techniques and psychological and behavioral therapy methods.

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