Pain therapy – stepchild of medicine

Pain therapy - stepchild of medicine

Many people fear getting sick. And almost everyone is afraid of pain. Pain is primarily a protective mechanism: it signals to us that something is wrong in our body. If the cause goes away, but the pain remains, it becomes an illness itself – and often a long ordeal for those affected.

Pain therapy: 10 million sufferers in Germany

According to the German Pain League, around eight to ten million people suffer from chronic pain in Germany alone. However, only a tiny proportion of them receive adequate treatment because there is a lack of facilities and specialists in this relatively new field of medicine.

Until a few years ago, pain therapy was not even an examination subject in the course. Some doctors, therefore, do not take their patients’ complaints seriously enough. Pain—often with no apparent organic cause—is often dismissed as imaginary or “psychic stuff” or something the patient must deal with himself.

However, it is often those affected themselves who do not or no longer seek treatment – for fear of being seen as a failure, fake or “psycho” or because of bad experiences with therapists.


Pain therapy: There are many causes of pain

Acute pain is a protective mechanism and usually disappears after hours or a few days – together with its trigger. Chronic pain, on the other hand, outlives its cause by months or even years and thus becomes an illness itself. In recent years, pain has been differentiated according to the diseases that caused it and the mechanisms of pain development.

For example, there is pain caused by inflammation, nerve pain or tumour pain. In addition to the intensity of the pain, this is also important for adequate therapy.

types of chronic pain

Pain that can become chronic includes:


learn neurons

The nerve pathways are transmitters of the protective stimulus pain. Scientists used to assume that nerves – like a power cable – are simple signal paths whose sole task is to transmit stimuli. We know that nerves also have a so-called pain memory: the longer and more frequently they transmit a pain stimulus, the greater the risk that the pain will become chronic and, thus, an independent disease.

Early adequate relief of acute pain is therefore significant to avoid the formation of a pain memory and to prevent the consequences of a chronic pain disorder such as depression and social loneliness.

Pain is not destiny.

If you have been suffering from pain for a long time, you should first confide in your family doctor. They can also refer you to a pain therapy specialist or a pain hospital. Don’t just accept that you’re in pain. Pain is not destiny – it is a disease that can be cured.

It is helpful if you already keep a pain diary and bring it with you to the first consultation. Record the type and frequency of pain accurately by time of day and activity (is it worse in the morning or evening? Does it improve or worsen with exercise? etc..)

The causes of the pain must be addressed in the doctor-patient discussion. A vicious circle between cause and effect has often already arisen: for example, pain from muscle tension and muscle tension in turn from pain. It is the task of the pain therapist to intervene here and break this circle with you.

Pain therapy: the cause determines the form of therapy

Chronic pain is a complex clinical picture with various triggers, which usually requires individually tailored and multi-pronged therapy. So, it’s not just about fighting the pain but also about positively influencing the quality of life and preventing further pain attacks. Migraine sufferers, for example, need in-depth counselling to reduce the risk factors that trigger an attack. This also includes a conscious diet, giving up smoking and alcohol consumption and a regular sleep rhythm.

Drug therapy (often as a combination of several substances) is helpful in most cases. It not only serves to reduce the pain but, above all, helps those affected by chronic pain to become active again and thus to be fit enough for further measures. Painkillers and anti-inflammatory drugs are used for mild to moderate pain, and opiates for severe pain, as well as herbal medicines (willow bark, devil’s claw, nettle leaves), antidepressants and antispasmodic drugs (anticonvulsants) for nerve pain.

In addition to effective medication, other types of therapy are also available to alleviate or eliminate pain. Some of them include Physiotherapy, massages, medicinal baths or electrical stimulation (particularly TENS = transcutaneous electrical nerve stimulation).


Acupuncture in pain therapy

Acupuncture has also proven effective. In many cases, it is covered in whole or in part by the health insurance companies; for knee joint arthrosis and back pain, it is included in the catalogue of benefits of the statutory health insurance companies.

Other alternative healing methods available to the pain therapist to supplement the therapy concept include chiropractic, osteopathy and Dorn therapy. These methods deal with the body’s mechanics and can help relieve tension and pain through specific influences on muscles, joints and nerve nodes.

A method that helps in many cases with chronic pain is the bio-feedback method. Here, those affected learn to become aware of their body’s processes and control them so that the pain decreases. There are also some so-called invasive procedures, in which either drugs for local anaesthesia are injected, analgesic pumps are used or “nerve pacemakers” (spinal cord stimulation, SCS) are implanted.

Pain therapy: don’t forget the psyche

Chronic pain not only affects the body, it also reduces the quality of life, can wear down the mind and lead to depression and even suicidal thoughts. The psychological component of pain therapy must, therefore, never be ignored. By dealing with pain-related illness, it is often possible to cope better with everyday life with pain and to break the vicious circle of pain development.

Many practices offer special programs for the psychological care of pain patients. In self-help groups and Internet forums, those affected can exchange ideas with each other, pass on advice and help and experience the feeling that they are not alone with their illness. A critical component is also relaxation methods such as autogenic training or progressive muscle relaxation, which simultaneously positively affect the psyche and body.

Strict standards for pain centres

Pain therapy facilities in Germany have only existed for a few years. They deal with the prevention, diagnosis and therapy of chronic pain disorders and must meet specific requirements and standards. Only then will permission be granted to describe itself as a “specialist facility for pain patients”.

In pain hospitals, outpatient pain clinics or pain practices, therapists from at least three medical specialities and psychologists and physiotherapists qualified for pain therapy work together on an interdisciplinary basis. You can find out where pain centres and specialists are near you from your family doctor, the medical association, or the Internet. Don’t wait – nobody has to live with pain!

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