Chronic pain

When the pain keeps coming back


In medicine, a distinction is made between acute and chronic pain. Acute pain is pain that is caused by a specific trigger, such as a bee sting or a cut. They have a warning function and protect the person from further injury. Once the illness or wound has healed, they subside again. Chronic pain, on the other hand, no longer accompanies specific illnesses, but occurs independently of them. If acute pain is not treated, recurs or lasts longer, this can lead to chronic pain.

This can also lead to changes in the nerve cells that trigger pain even if there is no longer a direct cause. Doctors refer to this as "pain memory". Detached from the original stimulus, chronic pain thus becomes a disease itself. Examples of diseases that can lead to chronic pain include back problems, rheumatism, diabetes mellitus, osteoarthritis or arthritis.

Symptoms of chronic pain


People with chronic pain often experience fatigue, sleep or eating disorders, which can develop into anxiety and depression. Affected individuals may limit their leisure activities, become withdrawn, and lose weight and interest in the world around them. Many different areas of the body can be affected by chronic pain. Pain is considered chronic when it

  • lasts longer than three months
  • can still be felt one month after an injury or illness has healed
  • recurs for months or even years
  • is associated with a chronic illness or injury that does not heal

Causes of chronic pain


Some chronic pain is clearly attributable to a trigger, such as in the case of osteoarthritis or arthritis. Often, however, chronic pain develops over a longer period of time, becomes more severe and spreads throughout the body. Then the cause is often difficult to determine. Essentially, chronic pain can be divided into:

  • nociceptive pain: this is pain that is caused by an injury or disturbance in the organs or tissues. Bone fractures, colic or a heart attack are examples. In this case, pain receptors, the so-called nociceptors, send out the pain signals. Depending on the cause, the pain can be burning, stabbing or throbbing. If organs are affected, they can also be dull or spasmodic.
  • Neuropathic pain: Such pain is the result of irritation and damage to nerve fibers, for example as a result of injury, shingles or diabetes, metabolic disorders or alcohol abuse. It can be seizure-like and abrupt, as well as accompanied by tingling, numbness, and hypersensitivity.
  • Pain due to inflammation: Infections and other inflammatory processes in the immune system can trigger pain as well. In some diseases, the immune system also targets the body's own cells, which means that persistent inflammation can cause chronic pain, such as in rheumatoid arthritis.
  • Pain due to altered pain processing: Impaired pain processing in the brain can be another cause of chronic pain. Examples of this type include irritable bowel syndrome or chronic cystitis.

Treatment & Therapy


In the case of chronic pain, the primary goal is to learn how to manage it and reduce its intensity so that those affected can enjoy as high a quality of life as possible despite recurring impairments. In this context, it is important to respond individually to the person and the respective pain.

For this reason, the therapy is usually based on various components from several disciplines. In addition to drug treatment, a combination of exercise and relaxation can help, integrating remedial gymnastics and physical therapies, as well as relaxation techniques and psychological-behavioral methods.

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