Accompanying factors

In addition to the main symptom of pain, other accompanying symptoms can also occur. Exhaustion and tiredness are not untypical for this disease. Furthermore, the persistent pain can in some cases cause nausea and even vomiting.

Psychological accompanying symptoms play an important role in chronic pain syndrome. Often anxiety disorders, depression or somatoform disorders are accompanying symptoms. The somatoform disorder describes a clinical picture in which physical disorders exist without any actual organic disease being present.

If a stressful situation has occurred before the chronic pain develops, or if the pain is perceived as particularly stressful, a post-traumatic stress disorder may develop. In some cases, it can be difficult to determine whether the psychological symptoms are an accompanying reaction to the pain or the triggering factors. The guiding principle of psychosomatic medicine is to link physical damage or symptoms with one’s own psyche.

Thus, it is believed that physical symptoms are triggered by psychological factors or influence them. The human psyche also plays an important role in the development of chronic pain. This will be explained further under the aspect of causes.

The own perception of pain can be influenced by past events as well as current events and changes the perception of a normally short-term pain so that it becomes chronic. Psychological risk factors that can support this chronification are for example continuous stress or other pain experiences in the past. Interestingly, an initial ignoring of the pain or an inconsistent treatment of pain can also be instrumental in making it chronic. Protective psychological factors that have a positive effect on pain are social support, especially from a partner. In addition, a positive attitude and acceptance of the pain can have a healing effect on it.

Causes

The chronic pain syndrome is a very complex clinical picture and the causative factors are not yet fully understood. In many cases, no exact cause of chronic pain can be found. However, some factors are known which can lead to the development of a chronic pain syndrome.

For example, long-term pain caused by accidents, tumour diseases or amputations can lead to certain changes in the body. Consequently, pain is no longer a symptom of a superordinate disease, but is now a disease pattern in its own right. The pain remains even if the original underlying disease is considered cured or sufficiently treated.

Neuropathic pain, also known colloquially as nerve pain, can influence the pain memory if the initial treatment is insufficient. This results in chronic pain that is difficult to treat. Finally, incorrect handling of the pain, for example in cases of extreme fixation or depressive disorders, can also lead to a chronic pain syndrome.

Psychological factors alone can also trigger chronic pain without finding a disturbance in the body. In medicine, stenosis is generally understood as a narrowing. In spinal canal stenosis, the spinal canal is narrowed, i.e. the space in the spine where the spinal cord runs.

The spinal cord is a bundle of nerves that can react with pain through compression. A frequent cause of spinal canal stenosis is a herniated disc. Here, the core of the intervertebral disc presses on the spinal cord, causing pain.

As long as there are no neurological symptoms, i.e. paralysis or numbness in the back, buttocks or legs, stenosis is usually treated conservatively. This includes physiotherapy and pain medication. The last therapeutic step is surgery.

If the pain is not treated adequately, it is possible that it will become chronic. This means that the patient will still have pain even after successful treatment of the spinal stenosis. This can last a lifetime and must be treated without fail, as chronic pain can often lead to mental exhaustion and depression and even suicide.