Pain disorder is when a patient experiences chronic pain in one or more areas, and is thought to be caused by psychological stress. The pain is often so severe that it disables the patient from proper functioning. Duration may be as short as a few days or as long as many years. The disorder may begin at any age, and more women than men seem to experience it.[citation needed] This disorder often occurs after an accident or during an illness that has caused pain, which then takes on a 'life' of its own.[1]
[edit] Sub-diagnoses
The DSM-4 specifies two coded subdiagnoses: pain disorder associated with psychological factors and pain disorder associated with both physiological factors and general medical condition.
[edit] Causes
The causes of pain disorder appear to be complex, including organic or medical etiologies such as injury, peptic ulcer and fibromyalgia; stress caused by continuing, severe or badly managed pain; impairment, loss and emotional distress, all of which may be caused by and in turn increase pain; and related depression and anxiety.[2]
[edit] Symptoms
Common symptoms of pain disorder are: negative or distorted cognition, such as feelings of despair or hopelessness; inactivity and passivity, in some cases disability; increased pain, sometimes requiring clinical treatment; sleep disturbance and fatigue; disruption of social relationships; depression and/or anxiety.[2]
[edit] Treatment
Treatment may include psychotherapy (with cognitive-behavioral therapy or operant conditioning), medication (often with antidepressants but also with pain medications[3]), and sleep therapy. According to a study preformed at the University of Miami School of Medicine, antidepressants have an analgesic effect on patients suffering from pain disorder. In a randomized, placebo-controlled antidepressant treatment study, researchers found that "antidepressants decreased pain intensity in patients with psychogenic pain or somatoform pain disorder significantly more than placebo"[4] .Other techniques used in the management of chronic pain may also be of use; these include massage, transcutaneous electrical nerve stimulation, trigger point injections, surgical ablation, and non-interventional therapies such as meditation, yoga, and music and art therapy.[2]
[edit] Prevention
Early intervention when pain first occurs or begins to become chronic offers the best opportunity for prevention of pain disorder.[2]
[edit] References
[edit] See also
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