Psychosomatische Störungen der Lenden-Becken-Hüft-Region

The International Association for the Study of Pain defines pain as an “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” The following notes, which are also particularly relevant for the psychological perspective, are also made: 1) “Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors.” 2) “Pain and nociception are different phenomena. Pain cannot be inferred solely from activity in sensory neurons.” 3) “Through their life experiences, individuals learn the concept of pain.” 4) “A person’s report of an experience as pain should be respected.” 5) “Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being.” 6) “Verbal description is only one of several behaviors to express pain; inability to communicate does not negate the possibility that a human or a nonhuman animal experiences pain.” In the case of lumbopelvic–hip complex dysfunction, the psychiatric-psychosomatic perspective can help to identify and treat possible psychological risk factors or associations with physical symptoms. Particularly in the case of chronic pain is a change of perspective necessary. The most common form of pain behavior is to ignore the pain, in order to maintain daily activities (suppressive pain processing). However, just as the fear of pain and avoidance behavior can lead to chronification, as can one-sided suppressive behavior. Flexible pain-coping strategies can provide a way out of the pain spiral. A holistic view of the body and mind may help to identify psychosomatic factors that contribute to the development or maintenance of symptoms. Appropriate multidisciplinary treatment can then address both physical and psychological aspects, such as anxiety, depression, somatization, traumatization, misuse of pain medication, sleep disorders, sexual dysfunction, or suicidality, to support recovery and halt chronification of the pain spiral.