Chronic pain can be avoided
Chronic pain and its treatment were central topics at the 9th German Interdisciplinary Pain Congress in Frankfurt, which is coming to an end this weekend. One of the results: the right treatment from the start could help prevent chronic conditions such as phantom pain after amputations. Around 600,000 pain patients visit German medical practices every quarter. Researchers now know that the so-called chronification of pain is a learning process. It is based on constant repetition, as Gerhard Müller-Schwefe, President of the Pain Therapy Colloquium, explains: "Over time, the nerve cells form a pain memory, so they change their information structure and processing."
Even minor stimuli such as touching are then interpreted as pain. The phenomenon occurs when acute complaints have not been adequately treated. An example is shingles. Even after it has long since healed, around 20 percent of patients feel burning pain. Almost all could be spared this fate if the pain had been treated with a nerve block during the first ten days of the illness. Müller-Schwefe: "A local anesthetic is injected that interrupts the excitability of nerves. We thus prevent the pain information from being passed on via the nerve to the pain cells in the central nervous system."
The phantom limb pain can be prevented in a similar way. In an amputation, the severing of the nerve cells causes veritable thunderstorms of pain in the spinal cord. The cells remember this pain, they turn into pain cells. Proper treatment could prevent this, says Müller-Schwefe: "The modern strategy is to use a local anesthetic either on the nerve itself or in the vicinity of the spinal cord before cutting the nerve. In addition, sufficiently strong painkillers should be given beforehand to suppress the excitability of the nerves."