Pain is by far the most widespread health disorder in everyday life. It not only reduces the quality of life, but also the satisfaction with life as a whole. This is evident from data from the Federal Health Survey, a representative study of the Robert Koch Institute on the state of health of the population in Germany.
Pain is subjective
Pain is always a subjective sensation, which is also described very differently by those affected: they can express a feeling ("agonizing", "paralyzing") or refer to a sense quality ("burning", "piercing", "oppressive"). ).
In the consultation, this can serve as the first indication of the nature and cause of the pain for the pharmacist. Pain perception and processing depend on different internal and external factors.
These factors of pain include, for example:
- general health
- previous pain experiences
- respective time of day
Pain types show age-related frequency distribution
In each stage of life typical situations occur that are associated with certain physical and mental stress and can cause acute pain. Thus, training and study are often associated with stress, tension and lack of sleep. If the recovery periods are inadequate, tension headaches can be the result. In the Federal Health Survey, 48.5 of the surveyed women and 27.5 percent of the surveyed men under the age of 30 said they had suffered from headaches over the past seven days.
With age, the incidence decreases, and is in the age group of 60-69 years, only about half. Lack of exercise and monotonous, sedentary activities characterize the modern working environment - a high risk of tension and acute back pain. Their frequency increases steadily during the working time and is significantly higher at the age of fifty than at the age of 30.
Pain in the leg and hip also increases during life and is most common in advanced age. Excessive and unfamiliar activities can overwhelm older people and cause acute pain in the musculoskeletal system.
Chronobiology of pain experience
In the context of sensitivity to pain, especially interesting are the results of chronobiology, a science that explores the rhythmic changes in bodily functions. The body's own processes are subject to physiological processes that recur in certain periods of time.
Responsible for this are genetically defined internal timers, but also external clocks such as the day-night rhythm. Under natural conditions, the "internal clocks" are synchronized by the periodic signals of the environment with the environmental cycle to which they are adapted. In humans, more than 100 different rhythms of varying duration are known.
The circadian rhythm
The best-known biorhythm is the circadian rhythm that follows each cell of the body and which, at around 24 hours, includes one day and one night. Pain sensations and reactions to pain stimuli also depend on daily rhythmic processes. Hartmut Göbel, Director of the Pain Clinic Kiel: "This is confirmed by the detection of circadian rhythms in the concentrations of endorphins and enkephalins in the corresponding pain-processing centers in the brain."
The sensation of pain in the afternoon is only one third as intense as in the morning, a reason why this time of day is particularly favorable for the visit to the dentist. Biorhythms can also modulate the effect of drugs on different levels. The effectiveness of analgesics is much stronger in the evening than in the morning. "However, the day-night rhythm for pain sensitivity is more pronounced in women than in men, " explains Göbel.
Gender-specific pain sensation
As the Federal Health Survey shows, women are almost twice as likely to be affected by acute pain over the course of a year as men. Women also complain of more intense and prolonged pain and their pain tolerance is at a lower level.
The causes are on the one hand in biological differences on the hormonal level, on the other hand, the body's own control system for pain in the sexes acts differently: women respond to pain rather emotional. Men, by contrast, use more instrumental and analytical strategies. They research the causes and try to solve the problem themselves.
Pain can therefore have different consequences for the sexes - in women, these are often fears, depression and sleep disorders. Men ignore pain more often. This entails the danger that they will become chronic faster and that long-term damage will be caused by overloading.
Pain conditions can be learned by the body. Repeated pain can lead to more intense and prolonged sensation of pain, as it reduces the pain threshold. Therefore, early and adequate pain relief is important, with drugs used responsibly and supplemented with non-drug treatments.
Here, analgesics with only one active substance are recommended. "Combination analgesics should be avoided in any case, because they are burdened with an increased risk of pain chronification, " said Goebel.
Particularly suitable and recommended by the DMKG as the first choice are preparations with acetylsalicylic acid (ASA). The active ingredient provides reliable relief for headaches and acute back, muscle and joint pain. ASA inhibits the synthesis of prostaglandins (hormone-like substances), which increase the activability of pain receptors as pain mediators.