Pain Disorder

"Pain disorder is defined as " a somatoform disorder characterized by a chief complaint of severe chronic pain which is neither feigned nor intentionally produced, but in which psychological factors appear to play a major role in onset, severity, exacerbation, or maintenance" according to the website http://medical-dictionary.thefreedictionary.com/pain+disorder. The pain is said to be so magnanimous, it renders the patient completely disabled from proper functioning in day to day life. The duration may last anywhere between a few days to many years at a stretch. The disorder does not have any specifications for age, and occurs more frequently in girls than boys. This disorder generally occurs after an accident or during an illness that has caused pain, which then manifests into a 'life' of its own. 

When the patient's primary complaint is of physical pain that is not intentionally produced or faked, referring to the terms Factitious Disorder or Malingering, and "psychological factors are judged to have played a significant role in the onset, severity, exacerbation, or maintenance of the pain," (http://behavenet.com/pain-disorder) this Somatoform Disorder can be diagnosed. Subtyping is based upon the categories of factors which is said to be leading causes:

·         Pain Disorder associated with psychological factors

·         Pain Disorder associated with both psychological factors and a general medical condition

·        Pain Disorder associated with a general medical condition (only): Psychological factors, if present, are judged to play no more than a minimal role. This is not considered a mental disorder so it is coded on Axis III with general medical conditions.

Common symptoms of pain disorder are: negative or distorted cognition, such as negative feelings of sadness or helplessness; inactivity and passivity, in few cases disability; increased pain, such as requiring clinical treatment; sleep disturbance and fatigue; severing of social relationships; depression and/or anxiety. Acute conditions last less than six months while chronic pain disorder lasts six or more months. There is no neurological or physiological basis for the pain. Pain is reported as more distressing than it should be if there was a physical explanation. People who suffer from this disorder may begin to abuse medication

The analysis and diagnosis is worse when there are a higher number of joint pain reported. Treatment may include psychotherapy (with cognitive-behavioral therapy or operant conditioning), medication (often with antidepressants but, on some occasions, with pain medications), and sleep therapy. Prescription and nonprescription pain medications do not help and can actually hurt if the patient suffers side effects or develops an addiction. Instead, antidpressants and talk therapy are recommended. Cognitive Behavioral Therapy  helps patients learn what worsens the pain, how to cope, and how to function in their life while handling the pain. Antidepressants work against the pain and worry. Unfortunately, many people do not believe the pain "is all in their head," so they refuse such treatments. 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.

- Siddarth Sudhakar (1114187) and Abhishek Soni (1114188)