Zusammenfassung
In der Erklärung der Genese von chronischen Schmerzen herrscht ein multidimensionales Schmerzmodell vor, das Funktions- und Regulationsstörungen auf biologische, psychische und soziale Aspekte zurückführt. Auf der biologischen Ebene spielen dabei neuronale, muskuloskeletale und (psycho-)biologische Prozesse eine Rolle, die durch körperliches Training oder psychosoziale Faktoren wie Stress beeinflusst werden. Diese Faktoren können mangelhafte Adaptationsmechanismen nach sich ziehen und somit zu negativen Langzeitveränderungen im peripheren und zentralen Nervensystem führen, was wiederum Chronifizierungsprozesse begünstigt. Ziel dieses Schwerpunktbeitrags ist es, einige Hypothesen zur Entstehung chronischer Schmerzen und deren Therapie zu diskutieren. Auf Basis ausgewählter Forschungsergebnisse werden durch Stress und körperliche Aktivität ausgelöste Adaptationsprozesse vorgestellt und in ihrer komplexen positiven wie negativen Wirkung auf die Entstehung und Therapie chronischer Schmerzen erörtert. Der Beitrag soll zur Diskussion über die die optimale Dosis-Wirkungs-Beziehung und Therapiekombination einzelner therapeutischer Konzepte anregen.
Abstract
The genesis of chronic pain is predominantly explained by a multidimensional pain model approach that is based on the dysfunctional influence of biological, psychological and social variables as key risk factors inducing aberrant long-term changes. Biological facets comprise adaptation processes on the neuronal, musculoskeletal and (psycho) biological level that can be influenced by physical training or psychosocial factors, such as stress. These factors can play a causative role in developing dysfunctional adaptation mechanisms, which in turn prepare the biological ground to facilitate negative long-term changes in the peripheral and central nervous systems. Hence, these processes can be assumed to be fundamentally involved in the transition from acute to chronic and persistent pain. The aim of this review article is to discuss hypotheses for the genesis of chronic pain and possible treatment strategies. Selected research results about maladaptive processes in chronic pain due to psychological stress and physical activity are presented in order to inspire discussions about the ideal dose-response relationship of physical activity and the combination of different therapeutic concepts.
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P.-M. Wippert und C. Wiebking geben an, dass kein Interessenkonflikt besteht.
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Wippert, PM., Wiebking, C. Adaptation an körperliche Aktivität und psychischen Stress im Kontext von Schmerz. Schmerz 30, 429–436 (2016). https://doi.org/10.1007/s00482-016-0147-0
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DOI: https://doi.org/10.1007/s00482-016-0147-0