Pain disorder is characterized by the ongoing sensation of pain that is not due to any explainable medical or psychological conditions. Pain is now recognized as a multidimensional entity, where it may be caused not only by physical conditions, but by thoughts, emotions and other bodily malfunctions as well. Pain may be present anywhere in the body and may occur at any frequency or severity. If medical conditions are present, the pain, either in severity or duration, extends beyond that which is expected based on medical research.
Symptoms of Pain Disorder
The most common symptoms of pain disorder vary greatly depending upon individual and circumstance. Pain may be felt in any part of the body, but the most common complaints describe lower back pain, headaches, chest pains or abdominal discomfort. Other common symptoms that accompany the pain when this disorder is present are as follows:
- Insomnia, lack of energy or fatigue
- Significant decrease in activity
- Depression and/or anxiety
- Feelings of hopelessness associated with the pain
- Disruption of normal activities, including work, home life and relationships
Causes of Pain Disorder
There are multiple causes for pain disorder, as shown by current research studies. While the initial pain may, in fact, be associated with a legitimate medical condition, severity and duration may be prolonged and worsen, rather than subside as expected. There are four main theories that scientists believe may lead to symptoms of pain disorder.
- The underlying medical condition may begin the onset of pain disorder. Certain diseases or illnesses center around pain, such as fibromyalgia, migraine headaches or ulcers. Pain during these episodes may be perceived to be much worse than it is, or it may actually exceed what medical science deems as a prognosis.
- The experience of pain differs amongst people. Pain which is not properly controlled or inadequately managed may lead to further symptoms and discouragement regarding any underlying cause. Additionally, unrelenting mental focus on the sensation of pain is thought to potentially worsen it by bringing the sensation to the forefront of the mind.
- When pain leads to impairment of movement, a patient may experience losses, such as jobs, participation in activities, or even relationships. These losses coupled with feelings of resentment or anger can increase pain levels.
- Depression or anxiety can exacerbate pain levels, especially when the focus lies on hopelessness for relief or future comfort.
Diagnosis of Pain Disorder
There are many factors that may come into play when diagnosing pain disorder. First, and most importantly, the pain cannot be entirely accounted for by a current medical diagnosis. A psychologist or psychiatrist must also rule out other disorders, such as somatization, where a patient has a long history of pain beginning before age 30, conversion disorder, which affects motor or sensory skills, mood disorders, or a condition that prompts the patient to complain of pain for external rewards, such as prescription pills or attention from family and friends. Certain questions within an interview and other scales of comparison can help a professional to understand what type of treatment may be best for the patient.
Treatment Options for Pain Disorder
There are many treatment options for pain, whether or not it's associated with pain disorder. If pain disorder is acute, meaning it's lasted less than six months, the primary goal of professionals will be to lessen or alleviate the pain. Prescription or over-the-counter medication is usually recommended. For chronic or ongoing pain, patients almost always require some type of therapy. Cognitive-behavioral therapy is very successful at helping people to understand what situations trigger certain responses that may lead to increased pain. Patients are then given exercises and activities that will help to divert attention from the condition. Operant conditioning therapy can help to eliminate behavior which may increase pain, such as passivity or inactivity. Alternative methods of healing can help considerably as well. These include acupuncture, meditation, yoga and other forms of physically therapeutic exercise.