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<p>Despite scientific advances, chronic pain remains difficult to diagnose and treat. For a&#xa0;long time, a&#xa0;dualistic understanding prevailed: pain without an identifiable organic cause was considered psychological in origin, leading to stigmatization and conflict-laden doctor−patient relationships. Imaging techniques often reveal abnormalities even in pain-free individuals, and surgical interventions are frequently unnecessary. Modern pain research understands pain as a&#xa0;complex interplay of biological, psychological, and social factors—not as a&#xa0;simple stimulus—response mechanism. Pain is learned, shaped by experience, and constructed by the brain, influenced by context and expectation. Pain is not the same as nociception; it is not a&#xa0;direct indicator of tissue damage, but rather a&#xa0;perception of potential threat. The new diagnosis of primary pain in ICD-11 integrates biological, psychological, and social factors and expands our treatment framework.</p>

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Das Gehirn ist heute die Psyche von gestern

  • 期刊论文

  • 发表日期：

    2025年7月24日

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  • Paul Nilges

摘要

Despite scientific advances, chronic pain remains difficult to diagnose and treat. For a long time, a dualistic understanding prevailed: pain without an identifiable organic cause was considered psychological in origin, leading to stigmatization and conflict-laden doctor−patient relationships. Imaging techniques often reveal abnormalities even in pain-free individuals, and surgical interventions are frequently unnecessary. Modern pain research understands pain as a complex interplay of biological, psychological, and social factors—not as a simple stimulus—response mechanism. Pain is learned, shaped by experience, and constructed by the brain, influenced by context and expectation. Pain is not the same as nociception; it is not a direct indicator of tissue damage, but rather a perception of potential threat. The new diagnosis of primary pain in ICD-11 integrates biological, psychological, and social factors and expands our treatment framework.