Pain Therapy - Stepchild of Medicine

Many people are afraid to get sick. And almost everyone is afraid of pain. Pain is initially a protective mechanism: it signals to us that something is wrong in our body. If the cause goes away, but the pain remains, it becomes a disease itself - and often a long ordeal for those affected.

Pain therapy: 10 million sufferers in Germany

According to the German Pain Association, around eight to ten million people in Germany alone suffer from chronic pain. But only a small part of it is in appropriate treatment. Because there is a lack of facilities and specialists in this relatively new field of medicine.

Until a few years ago, pain therapy was not even an examination subject in the study. Some doctors do not take their patients' complaints seriously enough. Pain - often without a recognizable organic cause - is often dismissed as imagination or "psycho-crime" or something that the patient has to deal with himself.

Often, however, it is the sufferers themselves who do not or no longer seek treatment - for fear of being considered a failure, a simulant or a "psycho", or because of bad experiences with therapists.

Pain Therapy: Causes of pain varied

Acute pain is a protective mechanism and usually disappears after hours or a few days - along with its trigger. Chronic pain, on the other hand, survives its cause for months or even years, becoming itself a disease. In recent years, pain is differentiated not only from the causative diseases but also from the mechanisms of pain development.

For example, there is inflammatory pain, nerve pain or tumor pain. In addition to pain intensity, this is also important for adequate therapy.

Types of chronic pain

Pain that can become chronic includes:

  • Headache (also tension headache)
  • migraine
  • Drugs headache
  • back pain
  • Muscle aches
  • rheumatic pain
  • Neuralgia (nerve pain, eg trigeminal neuralgia)
  • Phantom pain after amputations
  • Pain as a result of tumors

Learning nerve cells

Protective Stimulus transmitters Pain is the nerve pathways. In the past, scientists assumed that nerves - much like a power cable - are simple signal paths whose sole function is to transmit the stimuli. Today we know that nerves also have a so-called pain memory: the longer and more frequently they transmit a pain stimulus, the greater the danger that the pain becomes independent, becomes chronic and thus becomes an independent disease.

Early adequate relief of acute pain is therefore very important to prevent the development of pain memory and to prevent the consequences of a chronic pain disorder such as depression and social isolation.

Pain is not a fate

If you have been suffering from pain for some time, you should first trust your family doctor. This may also refer you to a specialist in pain therapy or to a pain clinic. By no means simply find yourself in pain. Pain is not fate - it is a disease that can be cured.

It is helpful if you already create a pain diary and bring it with you for the first consultation. Record in it the type and frequency of the pain exactly according to time of day and activity (Is it getting worse in the morning or in the evening? Improvement or aggravation by movement? Etc.)

It is important that in the doctor-patient conversation on the causes of pain is addressed. Because often there is already a vicious circle between cause and effect: for example pain due to muscle tension and again muscle tension due to pain. To intervene here and break this circle together with you is the task of the pain therapist.

Pain therapy: Cause determines form of therapy

Chronic pain is a complex disease with multiple triggers, which usually requires a customized and multi-pronged therapy. So it's not just about fighting the pain, but also to positively affect the quality of life and prevent further pain attacks. For example, migraine sufferers need in-depth counseling to reduce the risk factors that trigger seizures. This includes a conscious diet, the cessation of smoking and alcohol consumption and a controlled sleep rhythm.

Drug therapy (often as a combination of several substances) is helpful in most cases. Not only does it help reduce the pain, it also helps the person suffering from chronic pain get back into action and be fit enough to take further action. Used are painkillers and anti-inflammatory agents for mild to moderate and opiates for severe pain, as well as herbal medicines (willow bark, devil's claw, nettle leaves), antidepressants and antispasmodic drugs (anticonvulsants) for nerve pain.

In addition to effective medicines, other types of therapy are available to relieve or eliminate pain. Physiotherapy, massages, medical baths or stimulation current (especially TENS = transcutaneous electrical nerve stimulation) are some of them.

Acupuncture in pain therapy

Acupuncture has also proven effective. It is in many cases completely or partially taken over by the health insurance companies; For knee arthrosis and back pain it is included in the catalog of benefits of the statutory health insurance.

Other alternative therapies available to the pain therapist include chiropraxis, osteopathy and spine therapy to supplement the therapy concept. These methods are concerned with the mechanics of the body and can contribute to the relief of tension and pain by certain influences on muscles, joints and nerve nodes.

One method that in many cases helps with chronic pain is the bio-feedback procedure. Here, the sufferers learn to become aware of the processes in their body and to control them so that the pain is less. In addition, there are a few so-called invasive procedures in which either drugs are injected for local anesthesia, analgesic pumps are used or "nerve pacemakers" (spinal cord stimulation = English spinal cord stimulation, SCS) are implanted.

Pain therapy: do not forget psyche

Chronic pain not only affects the body, but it limits the quality of life, can wring the mind and lead to depression to suicidal thoughts. The psychological component of pain therapy should therefore not be ignored. Often, dealing with the pain disorder, it is easier to cope with everyday life with pain and to break the vicious circle of pain development.

In many practices special programs for the psychological care of pain patients are offered. In self-help groups and internet forums, those affected can exchange views, give advice and help, and experience the feeling of not being alone with their illness. An important building block is also relaxation techniques such as autogenic training or progressive muscle relaxation, which have a positive effect on the psyche and the body at the same time.

Strict standards for pain centers

Pain therapy facilities in Germany have only been around for a few years. They are concerned with the prevention, diagnosis and treatment of chronic pain disorders and must meet certain requirements and standards. Only then will permission be given to refer to themselves as a "specialized facility for pain patients".

In pain hospitals, outpatient clinics or pain clinics, therapists from at least three medical specialties and psychologists and physiotherapists qualified for pain therapy collaborate on an interdisciplinary basis. Find out where pain centers and specialists are in your area at the family doctor, at the medical association or on the Internet. Do not wait - nobody has to live in pain!

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