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Specific pain therapy helps alleviate backache

Everyone knows what pain is, but even experts struggle to put it into exact words. According to a definition given by the International Association for the Study of Pain in 1979, "pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage". In contrast to previous interpretations that saw pain as a purely physical process, this also includes the personal way in which the pain is experienced. And so someone can be ill with pain even when the physical cause has long since healed or cannot even be found.

Pain is the guardian of our health

Nobody likes pain. Even so, pain shouldn't be evaluated in negative terms without any further ado. "As a symptom, for example, acute pain fulfils an important warning and protection function, showing that something is wrong. The body reacts accordingly and tries to alleviate further damage by taking countermeasures", explains Dr. Jan-Peter Jansen MD, Medical Director of Schmerzzentrum Berlin (Berlin Pain Centre). This is why the old Greeks referred to pain as the "barking watchdog of health". Pain occurs for example for a limited period of time in the case of inflammation or injuries and can usually be treated successfully by dealing with the cause.

 

Dr. med. Jan-Peter Jansen
Dr. med. Jan-Peter Jansen

But pain loses this positive alarm function when it becomes chronic. On the contrary, chronic pain wears the patient down physically and can eventually dominate all the patient's thoughts and feelings. Pain becomes an even worse burden to bear than the actual original illness. Persistent pain keeps going on and on and in time becomes a clinical symptom in its own right that has to be treated individually. It is also known that chronic pain causes changes in behaviour, depression and social isolation

Early therapy prevents pain memory

When pain signals recur constantly, the nerve fibres can change permanently and form a pain memory. As a result, even slight stimuli such as touch, warmth or stretching can suddenly be felt as pain. Many people who had to have a limb amputated also report this effect. The injury to the nerves caused by the amputation or loss of a limb develops a life of its own. The damage caused in this way leaves a memory trace in the central nervous system without there being a corresponding physical reason. This is also possible in the case of backache. "To prevent pain memory, the pain pulses have to be suppressed by suitable treatment early on", advises Jansen. Otherwise, pain loses its function as the body's warning signal, with the risk of becoming chronic, says the pain expert.

Pain is not always pain

The way pain is felt can vary greatly from one person to the next and is influenced by the mind. People who are anxious or feel greatly stressed are less able to relax. This in turn increases pain sensitivity. All in all, this leads to a vicious circle where pain and stress have a mutually reinforcing effect. On the other hand, a positive mood or distraction can help to reduce the pain. Some people have a higher pain threshold, others a lower pain threshold. Pain is felt, assessed and described on highly individual different levels.

Pain therapy permits exercise

Many patients with backache live according to the motto "An Indian Brave Knows No Pain" and grit their teeth unnecessarily. But this false bravery means that they fail to exercise enough if at all. Once again, this leads to a vicious circle which reinforces the pain until it becomes almost unbearable or chronic.

Instead, regular exercise is necessary to strengthen the muscles and sustain mobility so that patients can continue with their daily activities. But the severe pain experienced in many cases usually means that the physiotherapy necessary to achieve this effect has to be accompanied by adequate pain therapy.

The aim of pain therapy is therefore to choose suitable pain relief in an appropriate dose so that the patient has no or scarcely any pain all the time. "It transpires that a patient with less pain is more relaxed, less anxious and has more joy in life. One other very important point is that the patient can then also make an earlier start with active therapy such as physiotherapy", says the Berlin pain therapist Jan-Peter Jansen.

In the case of acute backache where the nerve roots are not affected, to start with the doctor will prescribe simple pain relief. Here paracetamol is the first choice active substance because of its minimum side effects. However, it only brings a low level of pain relief. And so paracetamol may possibly not be sufficient. In this case, non-steroid anti-inflammatory drugs (NAIDs) should be used. This group includes active substances such as acetylsalicylic acid, diclofenac and ibuprofen. They should not be taken for longer than six weeks. The side effects that NAIDs have on the digestive system and kidneys makes them unsuitable for constant use. People aged more than 65 are particularly at risk. However, the side effects rate is not the same for every substance. An augmented risk of gastric complications can be counteracted by preventive administration of omeprazole. Ask your doctor about the best solution for your specific case.