In Germany, several million people suffer from pain syndrome. There is the acute and chronic pain. While the acute pain results from an injury or organ disorder and is considered a warning sign, the chronic pain, the pain syndrome, forms from the acute pain to the independent disease.
What is the pain syndrome?
Pain syndrome is a pain condition for which no specific causes have been identified, but which has nevertheless become a medical condition. In this case, there is chronic (long-lasting) pain. In pain syndrome, the affected person feels the suffering, which, however, has no physical causes. The pain nevertheless becomes a burden, so that in many cases therapy becomes necessary. In pain syndrome, the chronic pain sensation lasts for a period of at least six months, or it recurs at short intervals. It is possible that the chronic pain syndrome occurs suddenly, for example, after an illness, but it can also begin insidiously, for example, through a burnout, a permanent, excessive physical exertion, an overstimulation of the nervous system.
Causes
Chronic pain is often triggered and maintained by a disease of the body. In addition, however, psychological factors also play a crucial role in the pain syndrome. Causes sometimes include diseases or disorders of the musculoskeletal system, for example, joints, muscles, tendons, and ligaments. Changes in the nervous system, for example polyneuropathy, can also be a trigger of the pain syndrome. Psychological factors are very often the cause of pain syndrome. This is also true in relation to the severity, the experience of pain or the maintenance of pain. A pain that results from a physical cause, for example a herniated disc or tension, can easily become chronic if the following psychological factors are present:
- Stress and emotional strain
- Anxiety that is pain related
- Passivity
- Schon- and false postures
- Perseverance strategies as dysfunctional behavior patterns
- Sensations and possible consequences of illness are dramatized
- Fear of pain
With regard to the perception of pain, the effects of previous experiences often flow. The interpretation of the stimuli and the behavior that is controlled accordingly are significantly affected. Acute pain stimuli lead to fear conditioning. The pain can thus be triggered and intensified, which increases the pressure of suffering. In the affected person, this leads to an exaggerated expectation of the sensation, combined with a fear that is often a constant companion. The pain determines the behavior of the affected person, because he wants to absorb the stress by adaptation reactions. Therefore, it is important not to attach too much importance to the pain syndrome in this case, if possible.
Symptoms, complaints and signs
In pain syndrome, the main symptoms include chronic pain that can occur in different parts of the body, persistent fatigue, concentration problems to exhaustion, and sleep disturbances. Often the back, neck, chest as well as the joints are affected by the pain. Recovery periods after exertion are unnaturally long. Headaches, migraines and toothaches also often occur in pain syndrome. The symptoms have existed for at least three months. Pain syndrome also manifests itself in secondary symptoms, for example, feelings of swelling in the feet, hands or face, morning stiffness, and irritable bowel, stomach and bladder. Also, hypersensitivity of the mucous membranes to increased anxiety, irritability, mood swings and depressiveness. Sensitivity to sound, light and cold is also frequently increased. Also included are cardiac arrhythmias, dizzy spells, shaky hands, pain in the kidneys, numbness, increased venous signs, nervous extremities, leg muscle cramps, period pain, a tendency to increase sweating, and a [Sexual unwillingness|decreasing sexual interest]].
Diagnosis and course of the disease
Diagnosing the pain syndrome is complex because of its very diverse forms.A pain diary in which all situations in which the pain occurs are recorded has proven to be very useful. In addition, all symptoms are noted. The intensity of the pain should be indicated on a scale. Often, the life situation of the affected person must also be taken into account, as relationships and feelings often influence the sensation of pain. This is accompanied by a physical, orthopedic and neurological examination, for example by ultrasound, CT, magnetic resonance imaging and a neurophysiological diagnosis. On the one hand, this serves the purpose of identifying diseases, but on the other hand also to exclude them in the pain syndrome. Incorrect handling of the sensation is often to blame for the worsening of the disease. Those affected often take more care of themselves in order to make the pain more bearable. However, sparing leads to muscle breakdown and decreased fitness and performance, which can increase the pain and lead to a downward spiral. Due to the constant stress of the pain, mental illnesses such as depression and burnout can also occur, as well as an increasing deterioration in mood. The pain syndrome can also cause significant consequences in the social environment, leading to a loss of hobbies, friends and often problems at work.
Complications
First and foremost, those affected by pain syndrome suffer from severe pain. These themselves occur thereby above all chronically, so that they occur also at night and can lead thereby to sleep complaints or to depressions and an irritability of the concerning. Furthermore, the patient may experience severe fatigue and exhaustion. Most sufferers are unable to concentrate and suffer from severe headaches or toothaches. Furthermore, the pain syndrome also leads to mood swings and a high sensitivity to sounds and light. However, the further course of the pain syndrome strongly depends on its cause. As a rule, organ damage is responsible, so that this must be treated. Likewise, the syndrome can lead to complaints of the heart or to paralysis and other sensory disturbances. The treatment is always causal and depends on the limitation of the pain and the treatment of the damaged tissue. Complications usually do not occur. However, most patients still rely on various therapies to restore movement to the affected regions.
When should you see a doctor?
Pain syndrome should usually always be treated by a physician. With this disease, self-healing cannot occur, so the affected person is always dependent on medical treatment. This is the only way to prevent further complications and other ailments. Self-healing does not occur in most cases of pain syndrome. A doctor should be consulted in the case of pain syndrome, especially if the affected person suffers from very severe pain that occurs permanently and without any particular reason. They do not disappear by themselves and have a negative effect on the quality of life of the affected person. Furthermore, permanent fatigue and exhaustion may also indicate the pain syndrome, it should be examined by a doctor. Many patients additionally suffer from sleep complaints, which can even lead to depression. If these complaints occur, a doctor must also be consulted. In the case of pain syndrome, a general practitioner can be consulted in the first instance. The further treatment depends strongly on the type of pain and its originating region and is carried out by a specialist. In this regard, the further course cannot be universally predicted.
Treatment and therapy
In order to successfully treat the pain syndrome, the first step is to determine the cause and factors that aggravate the pain. Medication as well as physiological, psychological and social measures provide support. On the one hand, medication can change the perception of pain, and on the other hand, it is thus possible to interrupt the faulty transmission of pain impulses. Non-steroidal anti-inflammatory drugs are often used for mild pain, and opioids for moderate and severe pain. Care must always be taken to ensure that no dependence develops. Anti-epileptic drugs are often prescribed for nerve pain.In addition, the following is helpful to treat a pain syndrome:
- Physical and occupational therapy
- Psychotherapy
- Acupuncture
- Transcutaneous electrical nerve stimulation
- Autogenic training or other relaxation techniques
- Exercise therapy
- Local anesthetics, for example, for migraine.
- Operations
- Change in lifestyle habits and diet
Therapy is basically dependent on the cause and is therefore determined individually. Often, the pain can not be eliminated completely, but at least reduced to a tolerable level.
Prevention
To avoid a pain syndrome, exercise cannot hurt. In addition, it is important to see a specialist if the pain persists for a long time. A healthy lifestyle and diet, avoidance of stress, and a stable social environment also play a role.
Aftercare
Chronic pain is a daily burden for every patient. In pain syndrome, symptoms persist for at least six months. The condition is treated with physiotherapy and psychotherapy. This also applies to aftercare. The goal of aftercare is to consciously deal with the chronic pain. In addition, the symptoms are to be alleviated and the quality of life of the person affected is to be improved. This makes it easier for him to cope with everyday life. The sufferer can receive medicine for the pain syndrome from the specialist. During follow-up care, the progress of healing is regularly monitored. An increased dose or more adequate medication is required if there is no noticeable improvement in the patient’s condition. Chronic pain often causes depression. The affected person suffers additionally. Psychotherapy counteracts this situation. During the sessions, the sufferer has the opportunity to talk about his or her feelings. Fear of further episodes of the disease is also common in pain syndrome. In such cases, behavioral therapy is useful. Stressful social contacts are considered another cause of pain. The patient should refrain from such acquaintances in the future. His general condition may improve significantly after this decision. An understanding approach to his illness also has a positive effect on his condition.
What you can do yourself
The pain syndrome represents a special challenge for the patient as well as his relatives. In the field of self-help, the affected person is well advised to maintain close cooperation with a medical specialist. Changes and abnormalities should always be discussed with a pain therapist. In addition, there are various mental techniques that can be used independently and without further medical care. They serve to reduce stress and change conscious perception. Techniques such as yoga, meditation, hypnosis or autogenic training can be used regularly to achieve an improvement in general health. Although these methods do not aim to achieve freedom from symptoms, they help to strengthen well-being in everyday life. Mental strength is supported so that the patient can deal with the pain syndrome in a more optimal way. The aim is to reduce the perception of pain, at least temporarily, and to focus attention on other areas of life. A positive basic attitude towards oneself and life are also beneficial and applicable in the context of self-help. Cognitive techniques help so that the sufferer can move toward an improved quality of life. Dealing with issues outside one’s sphere of influence can provide relief.
