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Mechanismen der endogenen Schmerzhemmung

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Schmerztherapie ohne Medikamente

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Zusammenfassung

Die endogene Analgesie gehört zur Bewegung. Die „conditioned pain modulation“ ist das menschliche Korrelat der „diffuse noxious inhibitory control“, einer Hirnstammschleife der Schmerzhemmung, assoziiert mit dem Kortex. Die Periostreizung ist direkt auf die Aktivierung ausgerichtet. Weitere Mechanismen sind die Offset-Analgesie, die zeitliche Summation, der nozizeptive kutanomuskuläre Flexorreflex, ein Index der spinalen nozizeptiven Verarbeitung, und die „hypertension-associated hypoalgesia“. Die „exercise induced hypoalgesia“ (EIH) ist bei Gesunden ein Element stark ermüdender Belastungen. Der Mechanismus ist komplex. Es gibt Gemeinsamkeiten, aber keine Übereinstimmung mit der CPM. Die Belastungsparameter bestimmen die Beteiligung der Schmerzhemmmechanismen. Die Stressachse ist wesentlich dabei. Schmerzpatienten bilden häufig noch eine therapierelevante EIH aus. Die Schmerztoleranz beruht auf Belastungen, die die affektiv-emotionale und die bewertend-kognitive Schmerzkomponente ansprechen.

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Laube, W. (2022). Mechanismen der endogenen Schmerzhemmung. In: Schmerztherapie ohne Medikamente. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63846-0_6

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