Osteopathy and chronic pain
How to manage a chronic pain ?
Contribution of osteopathy and manual therapy
Definition of chronic pain
“Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in these terms” (IASP).
The term "Sensory" means that we can specify the characteristics of the pain: its location? what to compare it to? its intensity? its evolution over time?
The term "Emotional" means that, by nature, the pain being unpleasant, it can be more or less bearable, painful, distressing.
Pain is a subjective and individual phenomenon, which makes it difficult to communicate.
Pain works like an alarm signal. Its main role is to protect the body. Without it, we would not be aware that there is a “physical” lesion (for example a fracture). It encourages us to pay attention to the injured area, to be aware of the danger (for example, a burn provokes an immediate withdrawal reaction to stop the injury), and to seek care.
​When the pain persists, it can also go “in memory”. Thus, in a situation that risks provoking pain that has already been experienced, the spontaneous, thoughtless reaction will be to avoid it.
Chronic pain characteristics
-
Persistence over time: pain persists well beyond the expected healing time, often more than three to six months.
-
Independence from initial stimulus: whereas acute pain is directly linked to an injury or illness, chronic pain may persist even after the initial cause has disappeared, or even without an identifiable cause.
-
Emotional modulation: Chronic pain is often associated with mood disorders, such as depression, anxiety and feelings of hopelessness, which can aggravate pain perception.
-
Central sensitization: Chronic pain is often linked to a phenomenon of central sensitization, where the nervous system becomes hyper-reactive, amplifying the response to normally innocuous stimuli (such as light touch).
-
Functional impairment: Chronic pain sufferers may experience a reduction in their ability to function in daily life, with disruption of sleep, mobility, and social and professional activities.
Factors of pain chronicization
-
Biological factors :
-
Nerve or neuropathic damage: Damage to the nervous system, as in neuropathic pain (e.g. diabetic neuropathy, postherpetic pain), can lead to persistent pain.
-
Prolonged inflammation: Chronic inflammatory diseases, such as arthritis or fibromyalgia, can perpetuate pain due to the continuous activation of nociceptors (pain receptors) .
-
Neuronal plasticity: lasting changes in pain processing at the level of neural circuits, such as hyperexcitability of spinal cord neurons or loss of natural inhibitory mechanisms, can maintain pain .
-
-
Psychological factors:
-
​​Stress and anxiety: Chronic stress and anxiety are major factors in the transition to chronic pain. Depression: Depression is frequently associated with chronic pain, not only as a consequence, but also as an aggravating factor. It contributes to a heightened perception of pain and makes pain management more difficult.
-
Catastrophism: A tendency to exaggerate the negative consequences of pain can reinforce sensitization pathways in the brain, thereby increasing perceived pain .
-
-
Social factors :
-
Social isolation: Lack of social support, whether at home or at work, can aggravate chronic pain by increasing stress and anxiety levels.
-
-
Economic factors:
-
Unemployment or financial problems can create a vicious circle where psychological stress and material difficulties reinforce pain and reduce opportunities for treatment or rehabilitation .
-
-
Behavioral factors :
-
Physical inactivity: Physical deconditioning is common in patients with chronic pain. Prolonged inactivity can aggravate pain by reducing muscle strength, flexibility and endurance.
-
Self-medication: Prolonged use of medications, such as opioids, without comprehensive pain management can lead to dependency and worsen pain through phenomena such as opioid-induced hyperalgesia.
-
Osteopathy and chronic pain
Rôle et Efficacité de l'Ostéopathie
L'ostéopathie est reconnue pour son efficacité dans la gestion de la douleur chronique, notamment par le biais d'approches manuelles non invasives qui visent à rétablir l’équilibre structurel et fonctionnel des différents systèmes corporels. Plusieurs études scientifiques mettent en avant l’effet bénéfique de l’ostéopathie, en particulier pour les douleurs musculo-squelettiques chroniques, comme les douleurs lombaires, les cervicalgies et les c´éephalées de tension. Les recherches indiquent que les techniques ostéopathiques réduisent la douleur et améliore la qualité de vie des patients tout en étant sans danger et sans effets secondaires pour le patient.
Les principaux syndromes douloureux chroniques traités en ostéopathie et en thérapie manuelle
Charbel J. Kortbawi, ostéopathe à Paris 16, spécialiste de la douleur chronique
​​La chronicisation de la douleur est un processus multifactoriel impliquant des dimensions biologiques, psychologiques, et sociales. Une approche multimodale est souvent nécessaire pour gérer la douleur chronique, impliquant des traitements médicaux, psychologiques et comportementaux pour contrer les différents facteurs contribuant à la persistance de la douleur.
Mr Charbel Kortbawi, ostéopathe à Paris 16, a effectué le diplôme universitaire, gestion de la douleur chronique à l'Université Paris Sorbonne, ainsi que le diplôme douleur et motricité humaine à l'Université polytechnique Hauts de France, il sera apte à vous aider dans la gestion de votre douleur et ce que l'ostéopathie peut apporter dans ce domaine.
