When doctors find no physical cause for chronic back pain, sufferers feel left alone. The odyssey from practice to practice ends in many cases with the pain medic, who can alleviate the symptoms but cannot remedy the cause. If the boss puts pressure on the many sick days, the psychological stress increases enormously. US researchers are now reporting in the journal "Nature Neuroscience" that they have discovered the cause of chronic back pain. Differences in the brain are said to be responsible for whether the pain subsides or becomes chronic.
Chronic pain with no apparent physical cause First, back pain begins with mild to severe pain. While most of those affected are free of pain again after a few weeks, others suffer longer, sometimes even permanently. However, doctors often find no physical cause for the pain. A well-known risk factor for chronic pain is the immediate taking of a protective posture. People who are prone to psychosomatic symptoms are also more often affected.
US researchers recently announced that they had discovered the cause of chronic pain in a study. "For the first time, we can explain why people who initially experience the same pain either recover or develop chronic pain," said Vania Apakarian of Northwestern University in Chicago, Illinois, who was involved in the study this discovery could encourage the development of new therapies.
For the one-year study, 39 patients were examined who had suffered from back pain for four to 16 weeks at the beginning. 17 other subjects were added who were healthy and acted as control groups. During the study period, each study participant was scanned four times using magnetic resonance imaging (MRI). By the end of the year, the back pain had improved in 20 patients. In the remaining 19 study participants, the pain became worse or remained unchanged.
Chronic pain due to excessive communication between two brain regions The researchers concluded that the better the connection between two specific brain regions - the so-called nucleus accumbens and the prefrontal cortex - the greater the risk of chronic pain. The brain areas are involved in learning processes, but are also involved in processing emotions. According to the researchers, this connection can be explained as follows: If the brain reacts with a strong emotion to an injury or the initial acute pain, it can more easily develop into a chronic condition, although the physical cause has long since been healed. Pain is stored in the brain as a misguided learning process.
Apakarian suspects that the affected brain regions are more stimulated from the outset in some people. The excessive interaction of the nucleus accumbens and prefrontal cortex in pain may be genetic or due to environmental factors. The scientists also observed a sharp decrease in gray matter in some areas of the brain in patients with chronic pain.
The study results could in future give medical doctors indications of who is at increased risk of chronic pain in order to take quick countermeasures. The longer it lasts, the harder it is for those affected to get rid of the pain.
In the case of chronic pain, often only the pain doctor helps. Between 13 and 18 million people in Germany suffer from chronic pain such as back pain. However, there are currently only 2,000 to 3,500 doctors in Germany who offer a special pain consultation. Appropriate care is also provided in around 150 regional pain centers. It's no wonder that pain medication has been raising the alarm for some time. According to the President of the German Society for Pain Therapy, Dr. Gerhard Müller-Schwefe.
Many patients have had a real odyssey from doctor to doctor until they get help from a specially trained doctor, a pain medic. On average, sufferers consult eleven different doctors before they come to a pain center and the onset of the disease is usually years ago. Experts see the reason for this in the excessive demands of many specialists in this area. You are now requesting a revision of the licensing regulations. (ag)
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