If the family doctor does not know anymore

German Pediatric Pain Center helps if the family doctor no longer knows what to do

08/13/2013

More and more children and adolescents, according to data from the German Pediatric Pain Center (DKSZ), suffer from chronic pain. Five percent of all children and adolescents aged eight to seventeen are affected by chronic pain. in the „lighthouse“, a unique therapy facility of the Vestische Children and Youth Clinic in Datteln, Germany, the young patients learn how to treat their pain „unlearn“ can.

Family doctor often can not help children and adolescents with chronic pain
For children with chronic pain is the „lighthouse“ often more or less the only chance to return to a normal life. Every year around 240 children are treated at the German Pediatric Pain Center (DKSZ), who can no longer cope with their everyday lives due to chronic pain. At the same time, 20 children live in the ward, where they share a room for two. The patients learn that they are not alone with their problem.

„In the meantime, around 350,000 or five percent of all children between the ages of eight and 17 years in Germany suffer from extremely debilitating, recurring pain. Tendency rising ", explains Boris Zernikow, head of the DKSZ, opposite the news agency „dpa“. Most of the family doctors are with the children who are in the „lighthouse“ treated with their Latin at the end, because an organic cause is usually not underlying the pain. At the DKSZ, specially trained doctors, psychologists and caretakers look after the children and adolescents during their three-week stay.

Chronic pain sensation is based on a mixture of biological, psychological and social factors
„In our therapy it is about showing the red card to the pain and breaking out of the vicious circle of chronic pain. "Zernikow explains that although the cause of the complaint is unknown and no organic trigger can be found, the head, abdomen or As Zernikow explains, the chronic pain sensation is based on a mixture of biological, psychological and social influences, which can cause pain that would have only been temporary, for example through a school subject in which the child has a bad grade. If the child is allowed to stay at home, they will receive one „reward“ for the pain that can manifest itself. „Chronic pain can be learned if you have it, "explains the expert. „We therefore need to know what sustains the pain and make the brain unlearn the chronic pain sensation. "

To find out what is causing the pain in the children and adolescents, search the doctors and psychologists in the biography of patients for possible triggers. This can be, for example, a learning disability or interpersonal problems. The parents are involved in the treatment of their children. So once a week a family therapy session takes place. „They learn there how they have to deal with their treated child at home, so that they can optimally support the child on the way to health, "reports Zernikow.

Chronic pain as a demarcation against the environment
One of the patients is 15-year-old Lena, who has been treated in the DKSZ for two weeks for chronic headaches. Previously, she dropped out of school for three months because of the complaints. In their case, the chronic pain seems to function as a kind of outward delimitation. As a result, the girl defends herself against over-appropriation by her environment. „I have learned to differentiate myself and not to let this matter to me anymore, "Lena tells the news agency, „transforming black thoughts into colorful thoughts. "To make them fit for everyday life is one more thing before they are released „stressful day“ for therapy, in which she has to take care of the ward from 6:00 am to 8:00 pm, such as waking or cooking her fellow patients. As Zernikow explains, the treatment should be quietly exhausting. „We are not a spa facility. "This is how Lena should learn through the tight daily routine that she does not have to pay attention to the pain. „When the brain is distracted, there's no time to worry about the pain, "says the expert.

Chronic back pain could be caused by close association of two brain regions
US researchers reported () in June last year in the journal „Nature Neuroscience "that they have discovered the cause of chronic low back pain with no apparent organic cause, suggesting that differences in the brain may be responsible for whether the pain subsides or persists chronically, thus increasing the risk of chronic pain the more the two brain regions These areas of the brain, on the one hand, are involved in learning processes, but on the other hand, they also influence the processing of emotions. "As the researchers further report, a strong emotional response to an injury or death may be present initial acute pain is more likely to trigger a chronic condition, even though the physical cause has long since been healed, and the sensation of pain is then stored as a misdirected learning process in the brain.

The researchers suspect that the excessive interaction of nucleus accumbens and prefrontal cortex is due to some people of genetic origin or even to environmental factors. In patients with chronic pain, the researchers were also able to observe a significant decrease in the gray matter in some areas of the brain. The findings of the Americans could help to identify an increased risk of chronic pain in those affected, to quickly take countermeasures. For patients with chronic pain, the longer they last, the harder it is to get rid of the pain. (Ag)