Chronic pain: The Science Of Unlearning Pain: A New German Approach To Chronic Suffering | DIE ZEIT
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Sometimes the stabbing<br>pain was almost unbearable. For six years, Susanne Ganter has been tormented by<br>nerve pain in her face. It is a pain that keeps returning. Every few seconds it<br>shoots through her, causing her to panic and sending her back to the doctor<br>again and again. "There had to be a cause," says the 67-year-old. "I could show<br>exactly where the pain was coming from."
It all started with a dental appointment where she had a<br>bridge fitted. At first, there was only pressure, then it turned into sharp,<br>stabbing pain. The dentist didn’t believe her, so she switched practices. The<br>next dentist only gave her a mouthguard to stop grinding her teeth, but the<br>pain persisted.
What began as a minor dental procedure became a<br>neverending ordeal. Over the years, numerous procedures followed. Ganter<br>underwent several root canals, then a dentist extracted the painful tooth, and<br>she received first a temporary implant, then a permanent one. In addition,<br>there were countless X-rays, accompanying therapies such as massages,<br>physiotherapy, relaxation exercises, and finally costly<br>complementary treatments with an osteopath and craniosacral therapy.
"At some point," says Ganter, "you’re ready to do<br>anything to finally get rid of the pain."
Chronic pain is defined as pain that lasts longer than<br>three months. In almost half of all cases, it is back pain, followed by knee<br>pain and headaches. Osteoarthritis and herniated discs are the most common<br>causes. In some cases, the pain is constant, while in others, like Susanne Ganter’s, it returns again and again.
False alarm<br>Whether it is a sore tooth, a broken finger, or an<br>inflamed appendix, pain pushes everything else into the background. This is<br>useful, because acute pain is a vital warning signal from the body: attention,<br>there is an injury, take care, prevent further damage. Pain even tells us where<br>the danger lies. Normally, it subsides once the threat is gone, once the broken<br>finger has healed or the infected tooth or appendix has been treated. But sometimes the pain<br>lingers.
It becomes independent, detached from its cause, and<br>loses its biological function, like a smoke detector that keeps going off for<br>no reason. The insidious thing is that sufferers continue to experience the<br>pain as acute; the body’s own alarm system stays on red alert. Unlike the other<br>human senses, the body cannot get used to pain. On the contrary, it keeps both<br>body and mind under constant stress. Despair grows. People’s daily lives become<br>restricted, and they often find no satisfactory answers from doctors.
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Susanne Ganter had a similar experience. "I could feel<br>exactly which tooth hurt," she says. The petite woman with shoulder-length<br>gray-blonde hair sits at a conference table in the interdisciplinary pain<br>center at the Freiburg University Hospital and repeatedly points to a spot in<br>her upper jaw, above the right canine. She was convinced that something was<br>wrong there. That is why she kept seeking more dental treatment. But none of it<br>helped, and no one could find the cause.
Pain memory<br>But how can pain persist when no<br>cause can be found? The answer lies in the nervous system and the way the<br>brain processes and evaluates pain stimuli. In the body, nerve fibers are<br>responsible for sensory perception. Nerve endings detect external stimuli such<br>as heat, cold, or pressure and convert them into electrical signals. If these<br>receptors are activated repeatedly, their threshold lowers, and the nerve sends<br>signals more quickly.
For electrical signals to be felt as pain, they must<br>travel through the spinal cord to the brain. The spinal cord acts as a filter,<br>checking whether the signal is strong enough to be passed on. It also<br>recognizes how often a stimulus has already been transmitted from a particular<br>location. If the same pain pathways are activated repeatedly, they grow<br>stronger, like a narrow trail that turns into a wide road over time. This is<br>how pain memory develops. Eventually, even a mild stimulus can trigger severe pain.
Chronic pain develops first because the nervous...