Somatoform pain disorder

Alternative names 
Pain disorder; Body dysmorphic disorder

Definition
Pain disorder is persistent and chronic pain at one or more sites in which psychological factors are thought to play a role.

Causes, incidence, and risk factors

Pain is one of the most common reasons that people seek medical attention. In pain disorder, the suffering is so severe that it impairs a person’s ability to function. Furthermore, the pain itself is thought to be related to psychological factors, such as stress or unconscious conflict. Individuals with this illness may have other medical problems, though these fail to account fully for the pain.

Unfortunately, pain that is “psychological” in nature is often stigmatized both by medical professionals and the general public. A poor understanding of the connections between mind and body can lead to the misperception that if pain has a psychological cause it isn’t “real” and should be able to be controlled without medical or mental health treatment.

Symptoms

The primary symptom of pain disorder is chronic pain for several months that limits a person’s social, occupational, or recreational abilities.

Signs and tests

A thorough medical evaluation, including laboratory work, must be performed to investigate potential causes of pain.

Treatment

Some patients may resent the idea that their pain has a psychological component and may refuse treatment by a mental health professional. Nevertheless, many chronic pain syndromes, including those with a definitive physical source, can be effectively treated with antidepressants.

Supportive measures such as hot and cold packs, physical therapy, distraction techniques, and massage can also be helpful. Prescription and non-prescription pain medications are usually not effective and can make matters worse due to potentially serious side effects.

Support Groups

Comprehensive treatment at pain centers may be of benefit for people with this disorder.

Expectations (prognosis)

The outlook is worse for patients who have had symptoms for a long time or those who receive some benefit from their impairment, such as disability payments.

Complications

Surgical complications and addictions to prescription pain medications can develop if used inappropriately to treat this condition.

Calling your health care provider

Call your health care provider if you or your child is suffering from chronic pain.

Johns Hopkins patient information

Last revised: December 3, 2012
by Gevorg A. Poghosian, Ph.D.

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