The cause of chronic pain is in the brain
Chronic pain due to the brain
04/07/2012
If doctors do not find a physical cause for chronic back pain, sufferers feel left alone. The odyssey from practice to practice ends in many cases with the pain specialist, who can alleviate the symptoms but can not fix the cause. If then the boss due to the many days of sickness pressure, the psychological burden increases enormously. US researchers now report in the journal „Nature Neuroscience "that they have come to the root cause of chronic low back pain, with differences in the brain responsible for whether the pain subsides or becomes chronic.
Chronic pain without apparent physical cause
First, the back pain begins with mild to severe pain. While most sufferers are free of pain after a few weeks, others suffer longer, sometimes even permanently, among them. However, doctors often find no physical cause for the pain. As a known risk factor for chronic pain is the immediate use of a restraint. People who tend to have psychosomatic symptoms are more often affected.
US researchers recently announced that they have discovered the cause of chronic pain as part of a study. „For the first time, we can explain why people who experience the same pain at the beginning either recover or develop chronic pain, "explains Vania Apakarian of Northwestern University in Chicago, Illinois, who was involved in the study This discovery will encourage the development of new therapies.
For the one-year study, 39 patients were examined who had already suffered from back pain for four to 16 weeks. 17 other subjects were added, who were healthy and served as a control group. During the study period, four subjects were recorded by each study participant using magnetic resonance imaging (MRI). At the end of the year, the back pain had improved in 20 patients. In the remaining 19 study parts, the pain was sometimes worse or remained unchanged.
Chronic pain due to excessive communication between two brain regions
The researchers concluded that the better the risk of chronic pain, the better two distinct brain regions - the so-called nucleus accumbens and the prefrontal cortex - were linked. The brain areas are involved in learning processes, but also participate in the processing of feelings. According to researchers, this relationship is explained as follows: If the brain responds with strong emotion to an injury or initial acute pain, it can more easily develop into a chronic condition, although the physical cause has long since been cured. The pain is stored as a misguided learning process in the brain.
Apakarian suspects that the affected brain regions in some people from the outset are more excited. Excessive interaction of nucleus accumbens and prefrontal cortex in pain may be genetic or environmental. In addition, the scientists observed a significant decrease in gray matter in some areas of the brain in patients with chronic pain.
The study findings may provide clinicians with clues about who has an increased risk of chronic pain in order to quickly take countermeasures. For sufferers, it is even more difficult to get rid of the pain the longer they last.
For chronic pain, often only the pain medicine helps
Between 13 and 18 million people in Germany suffer from chronic pain such as back pain. However, there are currently only 2,000 to 3,500 doctors in Germany who offer a special pain consultation. In addition, adequate care is provided in around 150 regional pain centers. No wonder pain medication has been alarming for some time. According to the president of the German Association for Pain Therapy, Dr. med. Gerhard Müller-Sulfur.
Many patients have a veritable odyssey from doctor to doctor until they get help from a specially trained physician, a pain specialist. On average, sufferers consult eleven different physicians before entering a pain center and the onset of the disease is usually years old. Experts see the cause in the excessive demand of many specialists in this field. They are now calling for a revision of the licensing system. (Ag)
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