What is Psychogenic Pain?

Psychogenic pain not an official diagnostic term, but is used to describe pain that may be attributed to psychological factors. These factors may include certain beliefs, fears, memories or emotions that lead to the initiation or worsening of pain.

In the past, the term was often used to describe pain without a clear diagnosis or cause. It is in part for this reason that the term is less commonly used in current medical language.

Patients with psychogenic pain often have a history of unresolved psychological issues, which resurface unconsciously resulting in symptoms of pain. As the pain is usually perceived to be physical, the emotion and psychological aspects of the condition can easily be overlooked, when they should be at the core of the overall management plan.

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Characteristics

Psychological pain causes real physical pain, although the cause is more closely linked to psychological factors, rather than nociceptive or neuropathic changes. In many cases, pain that has been experienced in the past returns via pain memory and causes repeated episodes of significant pain.

It is common for patients to report stark pain of high intensity, such as a knife in the back or hot iron wounds. However, symptoms of pain may present in any area of the body of varied intensity and other types that are often associated with psychogenic pain include headache, muscle pain, back pain and stomach pain.

Mechanism

The mechanism of psychogenic pain is not well understood. It is believed that stressful environmental factors may be involved and associated with the changes that occur to the function state of the nervous system. However, there are likely to be a complex combination of events and factors that contribute to the pathology of psychogenic pain.

Depending on the individual case, there may be a particular event that can be traced to the initiation of symptoms and likely associated to the cause. This is often a positive sign, as it increases the ease of management of the condition when a starting point is known.

Management

The management of psychogenic pain is distinct from the management of other types of pain, primarily due to unique cause of the condition. As the pain occurs secondary to a psychological condition, the underlying issues must be addressed and managed to allow relief of the pain.

Psychotherapy is usually the first-line treatment for patients with psychogenic pain. It is important for them to have a safe and controlled environment to work through any unresolved issues that may be involved in causing the pain. Additionally, pharmacotherapy with some antidepressants and non-narcotic painkillers may help to relieve pain.

The prognosis of psychogenic pain is usually very positive and most patients find that the symptoms improve significantly within a short timeframe.

References

• http://www.grunenthal.com/grt-web/Grunenthal_Group/Patients/Definition_of_Pain/Pathogenesis/Psychogenic/en_EN/265300348.jsp
• https://my.clevelandclinic.org/services/anesthesiology/pain-management/diseases-conditions/hic-psychogenic-pain
• http://www.md-tips.com/pains/202
• http://www.orthopaedicmedicineonline.com/downloads/pdf/B9780702031458000946_web.pdf
• http://www.ncbi.nlm.nih.gov/pubmed/9710298