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Musculoskeletal Medicine

Chronic Pain

Evidence-based medicine!

Chronic pain is not a diagnosis; rather is a syndrome. 

Pain that continues for more than 3 months is called chronic pain. During the onset of pain, additional problems may arise independent of the diagnosis we make and depending on the history and characteristics of the patient, and chronic pain syndrome features can be seen:

  • Feeling the pain in a different and wider area than the initial state
  • Addition of complaints such as burning pain, numbness, tingling, chills
  • Tissues in the area where the pain begins to respond to stimuli such as touch that do not mormally cause pain 
  • Decreased sleep quality
  • Depressed mood and the belief that the patient will recover
  • Occupational productivity decrease
  • Restriction of social life
  • Decreased quality of life
  • Sweating, constipation, palpitations and blood pressure fluctuations


The reasons for these developments are as follows and are not of psychological origin:

  • Pain threshold in the nerves in the area where the pain begins
  • These nerves also stimulate neighboring nerves in the spinal cord, where they transmit pain
  • Much more of the pain felt in the spinal cord is transmitted to the brain than it normally controls sweating, constipation, palpitations, blood pressure fluctuations by stimulating the limbic system (primitive brain) in the brain
  • When the upper part of the brain (cortex) is stimulated, pain creates thoughts such as disability and inability to recover


Chronic pain treatment requires a knowledgeable and experienced team. Treatment of chronic pain begins with knowing this first. It is necessary to start work after saving the patient from unnecessary examination and treatment attempts. After starting the correct diagnosis and treatment based on evidence, it is necessary to convince the patient that he will recover.

Physical therapy agents, manual techniques, exercise, drugs with proven efficacy in chronic bee and gradual return to active life with the treatment of the person's pain are the tools we use in the treatment process.

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