Pain

definition

Pain is a complex sensory experience. They arise through the activation of pain receptors (nociceptors). These are found in all pain-sensitive tissues and are activated in the event of (potential) tissue damage. They then pass the information on to the brain via the spinal cord. There the information is processed and perceived as pain. Most of the time, pain is a symptom associated with specific illnesses or injuries. Sometimes pain is also the focus of the clinical picture, such as B. in chronic pain syndrome.

Why is there pain?

This question can be answered quite easily. Even if pain is often uncomfortable and sometimes almost unbearable, it fulfills a vital function for the human body. They protect the body from serious injuries. Anyone who has touched a hot stove immediately understands the context. Pain is a warning signal, it protects the body from further tissue damage. This is true at least for acute pain. In the case of the hotplate, the pain in the reflex arc is processed directly at the spinal cord level. This triggers a motor response, the hand is withdrawn. We only become aware of the pain and this action afterwards. It is therefore vital for the body to feel pain and to be able to react accordingly. This applies to all living things.

What does pain mean?

Pain in its acute form is essential for the body to survive. They indicate (potential) tissue damage; which can then be responded to by the central nervous system. Therefore, pain is often seen as a warning sign. However, pain can also mean something else. If the pain loses its function as a warning signal and occurs for more than 3 to 6 months without an acute cause, one speaks of a chronic pain syndrome. Here the pain has its own disease value and is no longer just a symptom of an illness. This always leads to psychological changes in the person concerned and is also a high burden for the personal environment. In general, you should always take pain seriously, especially if it persists over a long period of time without a recognizable cause for the person concerned. In this case you should consult your general practitioner to be on the safe side.

Can you imagine pain?

According to the current state of science, this question can be answered with a very clear no. Even if, after extensive medical diagnostics, no organic correlate can be found for the pain, it is still the case that the pain is real. The patient suffers from it. There is also a close connection between pain and the psyche in acute pain. With chronic pain, however, it is usually a mental wound that leads to pain. This can be a family conflict, stress at work, or an unprocessed traumatic experience.

What types of pain are there?

On the one hand, pain can be divided into acute and chronic pain based on its duration. Acute pain is limited in time, while chronic pain lasts longer than 3 to 6 months. Acute pain is usually the classic nociceptor pain, which indicates possible tissue damage.

Neuropathic pain or nerve pain must be distinguished from this. It occurs when nerve cells break. The neuropathic pain is usually described as shooting and like a dull burning sensation.

A third group distinguishes between psychosomatic pain. Here a mental illness is responsible for the complaints. Often there are also mixed forms (mixed pain). Back pain is a good example. This can be perceived as acute pain through wear and tear. But they are also aggravated by psychological stress. The nerve roots in the area of ​​the spine are also often irritated. This adds the neuropathic component.

Read more on the topic: Psychosomatics

Painkiller

Painkillers work very differently. They can be roughly divided into two groups: non-opioid and opioid pain relievers. Non-opioid pain relievers include many common household drugs such as ASA (Aspirin ®), ibuprofen or paracetmaol. They inhibit an enzyme (cyclooxygenase COX) that is responsible for the perception of pain in the brain. They are over-the-counter and can be taken for severe headaches or toothaches.

The opioid pain relievers have a completely different mechanism of action. They bind to special opioid receptors in the central and peripheral nervous system. Its analgesic effect is much stronger. Most of these drugs even require a special prescription from a doctor, because these drugs fall under the Narcotics Act. They have a high potential for addiction, so they are only used for very severe pain. They are used after operations or with cancer patients. Morphine, codeine and methadone are well-known representatives of this group. They are available in tablet form, for injection through the vein, or in the form of pain patches that release the active ingredient over a period of several days.

Find out more about the topic here: Painkiller

Sore throat

A sore throat is a common symptom. Especially in the cold season, sore throats are a frequent reason for advice in the general practitioner's practice. In most cases, the causes of a sore throat are harmless viral infections in the throat (pharyngitis). In the course of this, a real cold with runny nose and cough often develops. Such a viral infection is treated symptomatically. Anti-inflammatory drugs (e.g. ibuprofen) can be taken for fever and pain. A particularly stubborn virus is the Epstein-Barr virus (EBV). It causes glandular fever, which is often accompanied by a severe sore throat. Another cause of a sore throat can also be an infection with bacteria, e.g. B. tonsillitis or a lateral cord angina. In this case, an antibiotic is needed to treat the sore throat. Classic teething troubles such as measles, mumps or scarlet fever can also manifest themselves with a sore throat. It is therefore advisable to see your family doctor if the sore throat does not improve with the usual home remedies and over-the-counter medications.

Chest pain

Chest pain (chest pain) can have many causes. Some are harmless, others are life-threatening. Therefore, you should consult a doctor promptly if you have chest pain. After a brief history and physical exam, the doctor will usually do an EKG. In this way, he can determine whether there is a heart attack or cardiac arrhythmia. In addition to cardiovascular disease, lung disease can also cause chest pain. For example, the physical exam could reveal evidence of pneumonia or pleurisy. A collapsed lung (pneumothorax) can also lead to acute chest pain. These potentially life-threatening causes should therefore be ruled out. Musculoskeletal disorders are very often the cause of chest pain. These can usually be treated well with heat and pain relievers. Diseases of the esophagus and stomach come into question as a fourth category, for example if the patient states that the symptoms are related to food intake or reports other accompanying symptoms such as nausea and vomiting. In summary, it should be noted that the causes of chest pain are very diverse. Since some of them are life-threatening, chest pain should always be checked by a doctor.

Pain in the legs

Leg pain is usually caused by problems with the musculoskeletal system. So they are orthopedic in nature. These include sore muscles and excessive strain from sport, as well as cluster or knee joint problems. Signs of wear and tear on the joints often lead to osteoarthritis. But injuries also cause pain, for example a torn Achilles tendon, a torn muscle fiber or, in the worst case, a broken bone (fracture). In addition to muscles, tendons, bones and ligaments, there are also numerous blood vessels and nerves in the leg. If a blood clot blocks a deep leg vein (thrombosis), the affected leg swells and the patient feels pain. Pain also causes a circulatory disorder of the arteries, which is called peripheral arterial occlusive disease ("intermittent claudication"). Mainly smokers and diabetics are affected. Diabetics also sometimes experience nerve pain in the legs; due to neuropathy. Alcohol abuse or a vitamin B12 deficiency also lead to this type of nerve damage.

Find out more about: deep vein thrombosis

Pain in the knee

Unfortunately, knee pain is not uncommon, it has become almost a widespread disease. Here, too, there are rather harmless causes. But there can also be more dangerous diseases behind it. The knee joint is a very complex structure, so diagnosis and therapy of knee pain are often only something for specialists. It is advisable to consult a doctor at an early stage in the event of complaints, as this is the only way to identify damage to the joint quickly and treat it properly. Compared to other joints, the knee joint is more at risk of injury. In (sports) accidents, for example, meniscus damage can occur. A ligament strain or a torn ligament also causes knee pain. The bones involved in the joint can break when the force is exerted (e.g. a traffic accident). These joint fractures are often very difficult to operate. A fracture of the kneecap (patellar fracture) is also possible. Usually no surgical intervention is necessary here. Unfortunately, the knee joint is also a joint that wears down with age; the articular cartilage becomes less and the bone surfaces rub against each other. Pain occurs especially when exercising. But rheumatic diseases also damage the knee joint.They lead to joint inflammation and usually have to be treated with steroids.

Read more about the topic here: Rheumatism and osteoarthritis

Wrist pain

Jokes in the wrist are not uncommon and often lead to a significant impairment of the quality of life. For some occupational groups, even the ability to work is in danger in the long run. As always, it also applies here that the causes are diverse. As with all joints, overloading can lead to pain. This is a common problem in the hand. Patients in particular who have to perform the same movements over a longer period of time are at risk. Wrist pain is now widespread among people who work a lot with the mouse on the computer. But signs of wear and tear (osteoarthritis) also cause problems in the long term. Of course, you can also injure your wrist by falling, which inevitably leads to pain. Wrist fractures are particularly common in older people. If the pain occurs mainly at night and is characterized by an uncomfortable tingling sensation, it can also be caused by carpal tunnel syndrome. In this clinical picture, a nerve is pinched in the wrist. A small operation can fix this.

You can find out more about the topic here: Arthorse in hand joint

Pain in the back of the knee

Pain in the back of the knee can have a number of causes. On the one hand, they can occur through wear and tear as part of knee osteoarthritis. X-rays and an MRI examination would be carried out for the diagnosis. Injuries to the dorsal horn of the meniscus are also typical of pain in the hollow of the knee. This can also be determined by means of an MRI examination. Not to be forgotten when it comes to pain in the back of the knee is the so-called Baker's cyst. A cyst is a fluid-filled sac-like cavity in the tissue. It occurs with chronic effusion (fluid accumulation in the joint). If the cyst is so large that it presses on the nerve tracts, numbness occurs in the lower leg in addition to the pain.

Pain in the heel

Heel pain is called tarsalgia in medical terminology. They can appear at rest or under stress. Numerous diseases can be the cause of heel pain. With athletes, especially runners, overload is often the reason. In this case it helps to take a few days off. Even "wrong" running shoes can lead to heel pain. If you run long distances regularly, you should therefore invest in good footwear. However, heel pain can also be caused by a heel spur. This is a thorn-like bony outgrowth on the heel bone. Bursitis in the area of ​​the Achilles tendon can also cause the symptoms. This also applies to pathological changes in the Achilles tendon itself. The orthopedist is the best contact here. Last but not least, the heel is a bony structure. A heel bone fracture (heel bone fracture) also leads to pain. It does not always have to be preceded by an accident (trauma), there are also so-called fatigue breaks. These are also preferred by runners.

Find out more about the topics here:

• Pain in the back of the heel
• Heel bone pain
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Pain in the groin

Groin pain is common. This pain between the abdomen and thighs can have many causes. Often most people think of an inguinal hernia (inguinal hernia). This is not a broken bone, but a weak point in the abdominal wall through which parts of the intestines can "break through". But hip arthrosis can also cause pain in the groin. This also applies to tense muscles, irritated tendons and excessive strain (for example through exercise). Urinary stones or diseases of the testicles are very often accompanied by pain radiating to the groin. In rare cases, an accumulation of pus (abscess) is also responsible. A vascular bulge (aneurysm) in the pelvic or leg artery occasionally causes problems in this area. It is therefore always advisable to consult a doctor with groin pain in order to be able to rule out potentially dangerous causes for the pain. A physical examination is usually sufficient for this; An ultrasound can be performed as a supplementary diagnosis.

Pain in the upper abdomen

Mild abdominal pain is usually harmless and temporary. However, it can also hide serious illnesses. Pain in the left upper abdomen often originates from the stomach. An inflammation of the lining of the stomach (gastritis) or a stomach ulcer (ulcer) are painful. If the pain is more on an empty stomach or at night, an ulcer in the duodenum may be behind it. Pain in the right upper abdomen usually comes from the gallbladder or liver. The most common is definitely gallbladder inflammation (cholecystitis) due to gallstones (cholecystolithiasis). Inflammation of the liver (hepatitis) can also be painful. Last but not least, appendicitis can also cause pain in the upper abdomen; Depending on the position of the appendix, especially in pregnant women, appendicitis presents itself more like this than with classic pain in the right lower abdomen. Other diseases with upper abdominal pain are inflammation and tumors of the pancreas. Often the patients then complain of belt-shaped upper abdominal and back pain. You should therefore always consult a doctor. In addition to a physical examination, blood test and ultrasound, diagnostics also include an EKG. Especially in women, heart attacks initially only manifest themselves with pain in the left upper abdomen.

Shoulder pain

People of all ages can experience shoulder pain. The causes are very different. Often, diseases of the cervical spine also cause pain that only radiates into the shoulder. The orthopedist is definitely the first point of contact. Since the shoulder is a relatively flexible joint and is largely stabilized by muscles and ligaments, there is a high risk of injury. If the humerus head slips out of the joint socket, it is called a dislocation (shoulder dislocation). An injury can also damage the supporting muscles. This is called a rotator cuff. Injuries are then called rotator cuff tear or rupture, depending on the extent. Another disease that causes shoulder pain is impingement syndrome. Here a tendon is pinched between the humerus and the roof of the shoulder. In addition to pain, movement restrictions are also the result. Bursitis in the joint also causes shoulder pain. This can come from overwork, gout or rheumatism. Wear and tear lead to osteoarthritis. Individual tendons can store more lime ("lime shoulder"). The result is shoulder pain. Last but not least, pain in the left shoulder can also be caused by a heart attack, especially if there is chest pain and shortness of breath.

Find out more about the topics here:

• Osteoarthritis in the shoulder
• Pain in the upper arm
• Shoulder blade pain
• Pain in the collarbone

Pain in the elbow

Various problems can lead to pain in the elbow. Usually these are orthopedic problems. In the most common cases this is caused by overload and it is sufficient to spare the joint for a few days. Overuse-related pain disappears by itself. Tennis or golf players are often affected. In addition, as in any joint, osteoarthritis can occur through wear and tear. However, this is rather rare at the elbow joint. Bursitis on the elbow is quite common. Also, irritation of a nerve, for example by hitting an edge, leads to elbow pain. Injuries can lead to bone fractures, torn ligaments and a dislocation of the joint (dislocation). These clinical pictures all lead to pain and restricted mobility. In addition to the family doctor, the orthopedic surgeon is the first point of contact.

Also read the following articles:

• Broken elbow
• Elbow dislocation