Chronic pain: when pain becomes an illness
Chronic pains are a widespread phenomenon. As opposed to acute pains, which send alarm signals to the body, chronic pain can evolve to become an illness in its own right.
People feel pain through the nervous system, which includes the central nervous system, the brain, the brainstem and the spinal cord, as well as the peripheral nervous system, through which the nerves transmit the information from the brain and the spinal cord to the different body parts and to which the information returns. When we for example cut our finger, sprain our foot or hit our head, or after a surgery, we feel acute pain. This happens because the nerve endings are overstrained or damaged, making them send signals to the brain. This is how the body is informed that something is not functioning properly and that it needs to be taken care of. After treatment, the pain usually subsides.
When the pain becomes autonomous
However, damage to the central or the peripheral system can lead to chronic pains. In such a case, the pain looses it actual warning function. Such pains are usually due to an organ being damaged, but they evolve so as to become autonomous and eventually end up as an illness, leading in some cases to mental, social and physical impairments. This happens as a result of the neurons becoming autonomous, and which, even in the absence of pain stimulus, keep sending impulses to the brain. They have retained the pain-related information, and keep sending every single stimulus to the brain. As a result, the cells develop their own pain memory.
Chronic pain also occur when the trigger can no longer be removed – a physical cause that keeps triggering the pain – or when the pain becomes an autonomous illness.
Million patients are affected
Pain becomes chronic when it lasts longer than three to six months. An estimated 10 % of the population worldwide is suffering from chronic pain.
There are several causes for chronic pain. The most frequent reasons are:
- Back pain (for ex. discal hernia)
- Headache (for ex. migraine, tension headache)
- Rheumatic pains (for ex. arthritis)
- Neuropathic pain (for ex. neuralgic pain)
- Fibromyalgia (for ex. cartilage-related pain)
- Degenerative pain (for ex. arthrosis, osteoporosis)
- Tumour-related pain
- Phantom pain (often related to amputation)
The largest study so far concerning chronic pain, “Pain in Europe Survey 2003”, showed that a quarter of the people surveyed experienced back-related chronic pain. 16% of the respondents reported pain concerning the knee, 14% the legs, 10% the articulations and 9% the shoulders. A further 15% of the people interviewed mentioned chronic headaches.
According to this survey, articulation-related illnesses (such as arthritis and arthrosis) are the most frequent causes of chronic pain, followed by disc herniation, accidents / injuries, rheumatoid arthritis and migraine.
Role of the psyche
Many factors can lead to chronic pains, maintain them or increase them. Experts agree that psychological factors can also influence the emergence of chronic pains. A psychological disorder can lead to a more intensive pain experience and will in most likelihood contribute to the chronification of pain. As a result of an injury, a dynamic and capable person can experience a loss of self-esteem and subsequently undergo an emotional trauma.
Psychological disorders can also emerge as a result of chronic pains. Indeed, not only does enduring lasting pains represent a physical burden, but also an emotional one. For many patients, everything revolves around the pain. It completely fills a person’s world of emotions. Often, pain-afflicted people can no longer work, and subsequently suffer from depressive disorders, anxiety or adaptation disorders.
Chronic pains can also lead to social withdrawal, resulting in increased psychological problems. Indeed, the enduring pain or the constant fear of pain becomes overwhelming. Thus, the person suffering form chronic pains will avoid situations that previously triggered pain, and will progressively reduce physical and social activities.
Text: Patrick Gunti 09/2012
Translation: MyH 07/2016