Definition
The chronic pain syndrome is generally understood to be a painful condition that lasts longer than six months. It is important to distinguish acute pain from chronic pain. The acute pain lasts only for a short time and is linked to a pain event.
Acute pain occurs, for example, when one is injured, but ends when the wound has healed. The chronic pain is not directly attributable to a direct pain event. Thus chronic pain has no warning or protective function like acute pain.
Often chronic pain results from acute pain, for example when pain has not been adequately treated. Since the pain has no direct function in this case, the chronic pain syndrome is regarded as an independent clinical picture. In addition, a psychological component often plays a decisive role.
Chronic pain can be the result of a mental illness, but at the same time an acute, mental pain can turn into a chronic pain due to an additional physical component. The chronic pain syndrome is not a rare clinical picture. Over eight million people in Germany suffer from chronic pain.
Therapy is not easy, because the pain is not caused by a specific event. In acute pain, such an event is often easy to treat. Patients suffering from chronic pain must therefore be treated with many different methods at the same time.
Hronic disease and chronic illnessIn principle, four different types of pain can be distinguished, each of which can lead to a chronic pain syndrome. One cause for pain is the so-called psychogenic pain. This pain is not caused by a physical injury, but by damage to the psyche.
Thus, mental illnesses such as depression or delusional and anxious imagination can also lead to pain that must be treated. Neuropathic pain results from an injury or damage to the nerve itself. In the human body, nerves have the task of conducting sensory and pain perception from the periphery to our brain.
If nerves are damaged, the result is a permanent, strong pain experience. Common causes of neuropathic pain are viral infections, such as herpes zoster, or diabetes. Nociceptive pain is the pain we feel when we are injured.
For example, an incision in the skin causes the release of substances that irritate the nerves and thus lead to pain. If such pain occurs over a longer period of time, the nerves are over-stimulated and a so-called pain memory develops. This is the basis for the development of a chronic pain syndrome.
People also perceive nociceptive pain when the internal organs are damaged. The last form of pain is myofascial pain. This pain originates in the musculature and can occur, for example, in rheumatic diseases.
Irrespective of the origin of acute pain, it can always become chronic if it is not treated or handled correctly. Often a psychological component also plays a decisive role in chronic pain syndrome. The development can best be explained by an example.
An imaginary 50-year-old patient suffers a slipped disc, which causes him pain in his buttocks with radiation into his legs. In the early stages this is called an acute pain event. Out of stubbornness he ignores the pain and refuses to go to the doctor in the hope that the pain will go away on its own in a few days.
Only after months does the patient leave the doctor, who gives him a sick note and refers him to an orthopaedist. A total of six months elapses until the final diagnosis and therapy. This example shows three different ways of developing chronic pain syndrome.
Firstly, there is a decisive psychological component. By taking sick leave, the patient is indirectly rewarded for his or her pain suffering, as the patient does not only have to go to work. This increases his acceptance of the illness.
In addition, the patient notices that he cannot do anything against the pain by his own strength and in this way develops a feeling of powerlessness. This psychological attitude ultimately favours the development of a chronic pain syndrome. Men in particular live with the attitude that many clinical pictures subside simply by persevering.
For example, they take painkillers much less frequently than women. However, this chronic, untreated pain syndrome leads to the body becoming accustomed to pain and considering it normal. They say the body develops a so-called pain memory.
This is responsible for the chronification of pain. A final cause is the physical and mental fixation on acute to chronic pain. Just the idea of having pain during a certain movement can lead to a perception of pain in the brain.
Even the constant assumption of a relieving posture can lead to the development of a chronic pain syndrome. In summary, every patient who has pain for longer than a month should consult a doctor to treat the pain and possibly the cause as soon as possible. The therapy of acute pain is much easier and more efficient than that of chronic pain syndrome. Therefore, one should avoid letting a chronic pain develop.
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