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The genesis of chronic pain is explained by a biopsychosocial model. It hypothesizes an interdependency between environmental and genetic factors provoking aberrant long-term changes in biological and psychological regulatory systems. Physiological effects of psychological and physical stressors may play a crucial role in these maladaptive processes. Specifically, long-term demands on the stress response system may moderate central pain processing and influence descending serotonergic and noradrenergic signals from the brainstem, regulating nociceptive processing at the spinal level. However, the underlying mechanisms of this pathophysiological interplay still remain unclear. This paper aims to shed light on possible pathways between physical (exercise) and psychological stress and the potential neurobiological consequences in the genesis and treatment of chronic pain, highlighting evolving concepts and promising research directions in the treatment of chronic pain. Two treatment forms (exercise and mindfulness-based stress reduction as exemplary therapies), their interaction, and the dose-response will be discussed in more detail, which might pave the way to a better understanding of alterations in the pain matrix and help to develop future prevention and therapeutic concepts
The genesis of chronic pain is explained by a biopsychosocial model. It hypothesizes an interdependency between environmental and genetic factors provoking aberrant long-term changes in biological and psychological regulatory systems. Physiological effects of psychological and physical stressors may play a crucial role in these maladaptive processes. Specifically, long-term demands on the stress response system may moderate central pain processing and influence descending serotonergic and noradrenergic signals from the brainstem, regulating nociceptive processing at the spinal level. However, the underlying mechanisms of this pathophysiological interplay still remain unclear. This paper aims to shed light on possible pathways between physical (exercise) and psychological stress and the potential neurobiological consequences in the genesis and treatment of chronic pain, highlighting evolving concepts and promising research directions in the treatment of chronic pain. Two treatment forms (exercise and mindfulness-based stress reduction as exemplary therapies), their interaction, and the dose-response will be discussed in more detail, which might pave the way to a better understanding of alterations in the pain matrix and help to develop future prevention and therapeutic concepts
Pluvial floods have caused severe damage to urban areas in recent years. With a projected increase in extreme precipitation as well as an ongoing urbanization, pluvial flood damage is expected to increase in the future. Therefore, further insights, especially on the adverse consequences of pluvial floods and their mitigation, are needed. To gain more knowledge, empirical damage data from three different pluvial flood events in Germany were collected through computer-aided telephone interviews. Pluvial flood awareness as well as flood experience were found to be low before the respective flood events. The level of private precaution increased considerably after all events, but is mainly focused on measures that are easy to implement. Lower inundation depths, smaller potential losses as compared with fluvial floods, as well as the fact that pluvial flooding may occur everywhere, are expected to cause a shift in damage mitigation from precaution to emergency response. However, an effective implementation of emergency measures was constrained by a low dissemination of early warnings in the study areas. Further improvements of early warning systems including dissemination as well as a rise in pluvial flood preparedness are important to reduce future pluvial flood damage.