Change your mind and you change your pain?

Zusammenfassung

Seit Jahrhunderten prägte die strikte Trennung zwischen Psyche und Soma unsere wissenschaftliche Betrachtung und Behandlung des Schmerzes. Während akute Schmerzen mit ihrer biologisch sinnvollen Warnfunktion meist einer klaren organischen Ursache zugeordnet werden können und mit diversen Analgetika gut zu behandeln sind, treten beim chronifizierten Schmerz organisch begründbare Ursachen oft in den Hintergrund, während psychosoziale Probleme dominieren. Diese Beobachtung hat zur Modellvorstellung der bio-psychisch-sozialen Schmerzentstehung geführt. Die funktionelle Kernspintomografie hat in den letzten zehn Jahren mit ihren Ergebnissen zu einer Unterstützung dieser Modellvorstellung, insbesondere zur Aufklärung schmerzverarbeitender Prozesse auf zerebraler Ebene geführt, in die zahlreiche affektive und kognitive Kerngebiete komplex involviert sind. Auf der Basis der Erkenntnisse können inzwischen unterschiedliche nicht medikamentöse Therapieansätze insbesondere bei chronifizierten Schmerzen mit hinreichender Evidenz abgeleitet werden.

Summary

For centuries, the strict division in body and mind was the center of our understanding, treatment and scientific work about pain. Whilst acute pain with its biologically reasonable function in alerting the subject can be assigned to a distinct organic cause and treatment with different analgetics is well established, in chronic pain these organic causes are less important and psycho-social problems become more and more obvious. This led to the bio-psycho-social model of pain.The results of functional magnetic resonance tomography of the last ten years support this model by demonstrating the pain-processing structures in the brain, where different cognitive and affective cortical areas are involved in a complex way. According to these studies and results, different non-pharmacological treatments of chronic pain can be performed with sufficient evidence.

Schlüsselwörter

Chronischer Schmerz - Kernspintomografie - Kognition - Affekt - Kortex - eingebildeter Schmerz - limbisches System

Keywords

Chronic pain - fMRI - emotion. cognition - imaginated pain - cortex - limbic system

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