Neurobiology When the pain persists

With constant pain often suffer the psyche

02/13/2015

People who suffer from chronic pain usually have an odyssey through countless doctors' surgeries before they receive appropriate treatment. Because often a physical cause of the pain can not be determined. The fact that psychological problems can trigger chronic pain is often neglected in the diagnosis. This is reported by specialists from the Wagner-Jauregg hospital in Linz, Austria. According to this, the psyche even plays an essential role.

On average, it takes seven years for the psychosomatic clarification of chronic pain
In many patients, the chronic pain varies in intensity. Sometimes he is stronger, sometimes a bit weaker. Some days he even disappears completely. Then the victims hope that their martyrdom could finally come to an end. But a short time later, the pain returns, sometimes they are even stronger. Quality of life and friends is unthinkable for many pain patients. In her everyday life it's all about staying out and about.

„On average, around seven years pass before a psychosomatic clarification takes place for the first time“, explains Dr. Hertha Mayr, Head of the Department of Psychosomatic Medicine at the Landesnervenklinik Wagner-Jauregg. „A long ordeal, because only then is a corresponding diagnosis made, which takes into account both physical and mental and social causes and initiates a suitable treatment.“ Pain is considered chronic if it persists for more than three months. Usually an organic cause is assumed, as the patients felt their complaints in the body, explains the doctor. Therefore, the treatment of chronic pain is often focused exclusively on the body.

Eighty percent of sufferers receive painkillers without knowing the cause of the condition. „About 20 percent of them are on opioid painkillers set, without these can cause a significant pain reduction. As a result of these unilateral treatment strategies, there is increased chronification and there is a risk of inducing an increased sensation of pain through the painkillers“, informs the clinic in a message.

Close connection of stress and pain processing in the brain
Neurobiological research has shown that there is a close connection between stress and pain processing in the brain. „This means that pain is not only an indication of a physical condition, but may also be a leading symptom of primary mental illness such as anxiety disorder, congestion syndrome, depression, post-traumatic stress disorder“, explains Mayr. From their perspective, therefore, a holistic approach to therapy is important.

„The largest groups of chronic neurological pain are chronic headache and chronic back pain with and without radiation“, reports the head of the neurological department of the clinic, Tim J. von Oertzen. Chronic headaches can be caused by many different causes. „Many sufferers are afraid that persistent headaches could indicate a brain tumor. The vast majority of brain tumors express other symptoms than headaches, but the exclusion may have a calming and therefore therapeutic effect“, informs the clinic.

Holistic therapy of chronic pain necessary
Chronic back pain is often affected by stress. In particular, in phases where life-changing decisions are made, they are increasingly occurring. While headache imaging is often a reassurance for the patient - it's not just a brain tumor - MRI and X-ray on back pain often have the opposite effect. The reason for this are visible changes in the spine, which are not responsible for the pain. However, the patient sees a changed structure and makes them responsible for his complaints. „Therefore, it is important to diagnose chronic pain syndromes holistically and to include both organic causes, as well as somatoform-as-psycho-causes-in the diagnosis“, emphasized by Oertzen. (Ag)