Acute and chronic pain are not only in the amount of time (for pain more than three months, a criteria for chronic pain is), but also in terms of symptoms, the pathophysiological and therapeutic classification mechanisms (see Figure 1) . The differentiation of acute and chronic low back pain such as pain is of great importance for therapy and the expected course of the disease. Similarly, it can be treated without medication for chronic back pain today.
Acute pain: Injury Warning Signs
In acute pain, pain due to a (potentially harmful tissue) noxious stimulus means when the pain characteristics reflects nociceptive stimulus (eg, a sudden pain in lumbar disc herniation, sprains, appendicitis) . Chronic pain when pain occurs without noxious stimulus or that stimulus or clinical presentation proportional connection fails. Chronic pain can have relatively constant (z B. in cancer pain.), But can also be more or less progressive. Chronic pain can develop stimulating prolonged acute pain. In this case, it will store called forms of pain. They are characteristic of chronic pain and the pain of the memory that is managed by nerve stimulation long term inhibition, directly stimulating the matrix of small ® fibers can be reduced or indirectly through physical therapy, often (significantly ).
It is important to understand that a sharp pain, exercise warning function body. The term “acute” describes a blow, as the introduction of a needle for the pain or sore head venipuncture.
Said acute pain may frequently with pharmacological methods (analgesics, anesthetics) and are generally well treated usually by itself, resolve when the underlying cause is cured or eliminated. In acute pain, the direct and immediate control of pain is superficial. Acute pain usually shows a rapidly improving trend. So go the acute back pain in nine cases out of ten quickly treating back or even better, without even a place of therapy. In five to ten percent of patients with back pain, but it is chronic pain, so diagnosis and treatment is necessary.
Chronic pain: independent disease
If no typical throbbing pain persists and become independent, pain loses its alert function and is the so-called state of pain that can last for months or years. Chronic pain may remain relatively constant, or more or less be eliminated. Patients with permanent or recurring pain, some of the physical, psychological and social causes:
Much chronic disease is pain associated with the affected osteoarthritis, back pain, tumors / cancer, diabetes or pain of the wound.
The pain can be a disease, even if a physical (somatic) cause no or no longer exists – it has lost its biologically significant warning function. The result is an abnormal sensitivity to pain, now known as pain pain memory.Chronic therefore a different disease. It is fundamentally different from acute pain, which appears around the complex, time is not limited and often not identifiable triggers or biological sense. Chronic pain can become independent and severely affected patients’ quality of life. Chronic pain such as chronic low back pain or osteoarthritis, tend to deteriorate over time, and not only treated with painkillers. Instead, they need multimodal interdisciplinary therapeutic approaches that address the different dimensions of their origin (physical causes, psychological and social).
Chronic pain is not a normal state
Often a multimodal treatment of pain starts too late or at an advanced stage. Chronic pain should not be accepted as a normal resting state. Instead, with a therapist to try to pain therapy effective individual pain. On the basis of this form of therapy is the understanding of chronic pain as a disease in the context of bio-psycho-social. Especially with the multimodal pain therapy of chronic pain is a combination of medication, physical therapy toning, small fiber matrix Stimulation® and psychological / behavioral and nutritional approach to treatment / promising more specific patient.
Image: Effect of SFMS
The formation of a pain memory as “worst case”
International studies have shown that a strong and sustained by the body tissue pain can cause nerve cell transmission spinal and more sensitive following painful stimuli brain marrow. It follows that even light stimuli such as surface contact, excessive heat or pressure suddenly perceived as pain. Here hyperalgesia the pain processing system is so sensitive that mediated hypersensitivity to pain in the spinal cord, called developed. It even happens that those neurons sensitized also send pain signals to the spinal cord to the brain, so most of the pain signals in the spinal cord of the most distant body tissues are received. The sensitization process occurs in nerve cells continuously conducting not only the tissues (eg, skin, ligaments, muscles), instead, but especially in the spinal cord and brain.
These learning processes, reflected primarily in the spinal cord to a solidification of greater pain awareness are called “pain memory”. This is impressed by acute stimuli and remains effective even if the real causes of pain are already eliminated. the examination and treatment of neurobiological mechanisms that lead to chronic pain is anatomically and physiologically similar to those of acute pain (see above).
For chronic back pain, the bomedus chopsticks can help normalize the memory of the pain and lead to life schmerzfreierem.