The mind is very good at noticing pain, it is beneficial as it typically prevents the body from causing any more injury to itself, however sometimes the brain continues to send signals of pain despite the triggers being resolved.
Pain is described by the Oxford dictionary as a “Highly unpleasant physical sensation caused by illness or injury. Mental suffering or distress”
Our bodies contain massive networks of nerve receptors that transmit messages up the spine to the brain. Once these signals reach the brain, the brain figures out what area of the body is hurt, how badly it is hurt and what you should do to alleviate or minimise the pain.
However, sometime these messages get crossed and you may experience pain in a different area to where the nerve signals from. This is known as referred pain. Crossed signals can also lead you to experience pain where there is none. The fact that the subconscious mind can produce pain out of nothing can lead some to think that therefore this experience of pain is therefore all psychological. However this doesn’t mean that it doesn’t exist.
For example someone may mention they suffer from chest wall pain or pain radiating out of the arm. This is sometime confused for warning signs of a heart attack. But chest pain syndrome typically arises from underlying anxiety, depression or panic disorders. This underlying anxiety might also be a contributing factor to misdiagnosis.
The main contributing psychological factors are:
- Anxiety
- Bipolar
- Depression
- Obsessive-compulsive behaviour
- Panic attacks
Rubin (2005) researched pain in women and the results indicated that at least 40 to 60 percent of women and at least 20 percent of men with chronic pain disorders report a history of being abused during childhood and/or adulthood. This incidence of abuse is two to four times higher than in the general population. Patients with more severe or frequent abuse, usually during childhood and worse if sexual in nature may develop specific syndromes. These syndromes include post traumatic stress disorder, fibromyalgia, and other conditions characterised by repression, somatisation, and increased utilisation of medical care. Psychosomatic symptoms and dysfunctional behaviours may emerge as these patients seek attention and validation of their suffering, while paradoxically repressing painful memories of trauma.
However sometimes pain is caused by a previous injury that was left unhealed or it was healed but the emotional trauma was left untreated which can intensify the experience of the pain, or persist passed the healing process. Or psychogenic pain may lead someone to have an increased sensitivity to pain and experience a much greater degree of perceived pain.
Some typical symptoms of psychogenic pain:
- Constant discomfort despite taking medication
- Difficulty describing the location, quality and depth of pain
- Non-localised pains that encompass larger parts of the body
- Worsening pain independent of any underlying medical condition.
If someone has no physical indicators and potentially suffers from an emotional disorder the GP may be more inclined to think it may be psychogenic pain after performing a series of tests such as MRI’s, CT scans, blood tests, etc.
To help alleviate physical symptoms some methods include
- Getting physical therapy, especially when the muscles and joints are experiencing pain
- Making dietary changes
- Healthy exercise regimen
- Taking medication.
After potential physical cause of pain may have been dealt with, a psychiatrist, psychotherapist or psychologist may work with underlying triggers.
Some alternative treatments include:
- Acupuncture
- Behavioural training
- Family counselling
- Hypnotherapy
- Occupational therapy
- Transcutaneous electrical nerve stimulation (TENS), the use of electrical nerve impulses to relieve pain
Studies have found a good connection between reducing pain by developing better mind body relationships through activities like tai chi, biofeedback, progressive muscle relaxation, guided imagery, hypnosis, qi gong and yoga. (Morone & Greco, 2007). Yoga for example not only increases functional ability but also reduced the experience of pain for conditions like osteoarthritis, Low Back Pain, Rheumatoid arthritis and Kyphosis or fibromyalgia (Ward, Stebbings, Cherkin & Baxter, 2013).
Without treatment, psychogenic pain can lead to:
- alcohol abuse
- drug abuse
- fatigue
- irritability
- isolation
- loss of sleep
- memory loss
Research indicates if you suffer from depression you are more likely to suffer any kind of chronic pain and improvement in mood was linked to a reduction in arthritic symptoms. A study at university of Alberta found on average, depression had a four times higher likelihood of developing intense or disabling neck and low back pain than those who are not depressed while another study suggested 3 times higher rate of migraine rate in depressed patients.
Psychotherapy can reduce psychological symptoms of depression, bipolar, anxiety, panic attacks and obsessive compulsive behaviour. Talking therapies can give individuals experiencing chronic pain an opportunity to share their experience and reduce the burden as well as gain insight and mindfulness around psychological triggers of pain.
James Waldron
References:
Columbia-Presbyterian Medical Center, New York, NY 10032-3784.
Rubin, J. J (2005). Psychosomatic Pain: New Insights and Management Strategies. Southern Medican Journal. Southern Medical Journal. 98(11), 1099-1110.
Lef.org (1995-2007). Chronic Pain. Retrieved August 28, 2007, from the Life Extension Foundation Web site: https://www.lef.org/protocols/health_concerns/chronic_pain_01.htm.
Meyer RA, Ringkamp MR, Campbell JN, et al. In: McMahon SB, Koltzenburg M (eds). Wall and Melzack’s Textbook of Pain, Fifth Edition. Philadelphia: Elsevier Limited; 2006. Peripheral mechanisms of cutaneous nociception; pp. 3–34
Minddisorders.com (2007). Pain Disorder. Retrieved August 27, 2007, from the Encyclopedia of Mind Disorders Web site: https://www.minddisorders.com/Ob-Ps/Pain-disorder.html.
Morone, N. E., & Greco, C. M. (2007). Mind-body interventions for chronic pain in older adults: a structured review. Pain Medicine (Malden Mass.). 8(4), 359-375.
Va.gov (n.d.). Chronic Pain Primer. Retrieved August 28, 2007, from the United States Department of Veterans Affairs Web site: https://www1.va.gov/Pain_Management/page.cfm?pg=15.
Ward, L. Stebbings S., Cherkin D., & Baxter, G. D. (2013). Yoga for Functional Ability, Pain and Psychosocial Outcomes in Musculoskeletal Conditions: A Systematic Review and Meta-Analysis. Musculoskeletal Care. Accessed from: https://www.ncbi.nlm.nih.gov/pubmed/23300142
https://www.care2.com/greenliving/9-physical-symptoms-of-depression.html
https://www.tree.com/health/pain-types-psychogenic.aspx
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The mind is very good at noticing pain, it is beneficial as it typically prevents the body from causing any more injury to itself, however sometimes the brain continues to send signals of pain despite the triggers being resolved.
Pain is described by the Oxford dictionary as a “Highly unpleasant physical sensation caused by illness or injury. Mental suffering or distress”
Our bodies contain massive networks of nerve receptors that transmit messages up the spine to the brain. Once these signals reach the brain, the brain figures out what area of the body is hurt, how badly it is hurt and what you should do to alleviate or minimise the pain.
However, sometime these messages get crossed and you may experience pain in a different area to where the nerve signals from. This is known as referred pain. Crossed signals can also lead you to experience pain where there is none. The fact that the subconscious mind can produce pain out of nothing can lead some to think that therefore this experience of pain is therefore all psychological. However this doesn’t mean that it doesn’t exist.
For example someone may mention they suffer from chest wall pain or pain radiating out of the arm. This is sometime confused for warning signs of a heart attack. But chest pain syndrome typically arises from underlying anxiety, depression or panic disorders. This underlying anxiety might also be a contributing factor to misdiagnosis.
The main contributing psychological factors are:
- Anxiety
- Bipolar
- Depression
- Obsessive-compulsive behaviour
- Panic attacks
Rubin (2005) researched pain in women and the results indicated that at least 40 to 60 percent of women and at least 20 percent of men with chronic pain disorders report a history of being abused during childhood and/or adulthood. This incidence of abuse is two to four times higher than in the general population. Patients with more severe or frequent abuse, usually during childhood and worse if sexual in nature may develop specific syndromes. These syndromes include post traumatic stress disorder, fibromyalgia, and other conditions characterised by repression, somatisation, and increased utilisation of medical care. Psychosomatic symptoms and dysfunctional behaviours may emerge as these patients seek attention and validation of their suffering, while paradoxically repressing painful memories of trauma.
However sometimes pain is caused by a previous injury that was left unhealed or it was healed but the emotional trauma was left untreated which can intensify the experience of the pain, or persist passed the healing process. Or psychogenic pain may lead someone to have an increased sensitivity to pain and experience a much greater degree of perceived pain.
Some typical symptoms of psychogenic pain:
- Constant discomfort despite taking medication
- Difficulty describing the location, quality and depth of pain
- Non-localised pains that encompass larger parts of the body
- Worsening pain independent of any underlying medical condition.
If someone has no physical indicators and potentially suffers from an emotional disorder the GP may be more inclined to think it may be psychogenic pain after performing a series of tests such as MRI’s, CT scans, blood tests, etc.
To help alleviate physical symptoms some methods include
- Getting physical therapy, especially when the muscles and joints are experiencing pain
- Making dietary changes
- Healthy exercise regimen
- Taking medication.
After potential physical cause of pain may have been dealt with, a psychiatrist, psychotherapist or psychologist may work with underlying triggers.
Some alternative treatments include:
- Acupuncture
- Behavioural training
- Family counselling
- Hypnotherapy
- Occupational therapy
- Transcutaneous electrical nerve stimulation (TENS), the use of electrical nerve impulses to relieve pain
Studies have found a good connection between reducing pain by developing better mind body relationships through activities like tai chi, biofeedback, progressive muscle relaxation, guided imagery, hypnosis, qi gong and yoga. (Morone & Greco, 2007). Yoga for example not only increases functional ability but also reduced the experience of pain for conditions like osteoarthritis, Low Back Pain, Rheumatoid arthritis and Kyphosis or fibromyalgia (Ward, Stebbings, Cherkin & Baxter, 2013).
Without treatment, psychogenic pain can lead to:
- alcohol abuse
- drug abuse
- fatigue
- irritability
- isolation
- loss of sleep
- memory loss
Research indicates if you suffer from depression you are more likely to suffer any kind of chronic pain and improvement in mood was linked to a reduction in arthritic symptoms. A study at university of Alberta found on average, depression had a four times higher likelihood of developing intense or disabling neck and low back pain than those who are not depressed while another study suggested 3 times higher rate of migraine rate in depressed patients.
Psychotherapy can reduce psychological symptoms of depression, bipolar, anxiety, panic attacks and obsessive compulsive behaviour. Talking therapies can give individuals experiencing chronic pain an opportunity to share their experience and reduce the burden as well as gain insight and mindfulness around psychological triggers of pain.
James Waldron
References:
Columbia-Presbyterian Medical Center, New York, NY 10032-3784.
Rubin, J. J (2005). Psychosomatic Pain: New Insights and Management Strategies. Southern Medican Journal. Southern Medical Journal. 98(11), 1099-1110.
Lef.org (1995-2007). Chronic Pain. Retrieved August 28, 2007, from the Life Extension Foundation Web site: https://www.lef.org/protocols/health_concerns/chronic_pain_01.htm.
Meyer RA, Ringkamp MR, Campbell JN, et al. In: McMahon SB, Koltzenburg M (eds). Wall and Melzack’s Textbook of Pain, Fifth Edition. Philadelphia: Elsevier Limited; 2006. Peripheral mechanisms of cutaneous nociception; pp. 3–34
Minddisorders.com (2007). Pain Disorder. Retrieved August 27, 2007, from the Encyclopedia of Mind Disorders Web site: https://www.minddisorders.com/Ob-Ps/Pain-disorder.html.
Morone, N. E., & Greco, C. M. (2007). Mind-body interventions for chronic pain in older adults: a structured review. Pain Medicine (Malden Mass.). 8(4), 359-375.
Va.gov (n.d.). Chronic Pain Primer. Retrieved August 28, 2007, from the United States Department of Veterans Affairs Web site: https://www1.va.gov/Pain_Management/page.cfm?pg=15.
Ward, L. Stebbings S., Cherkin D., & Baxter, G. D. (2013). Yoga for Functional Ability, Pain and Psychosocial Outcomes in Musculoskeletal Conditions: A Systematic Review and Meta-Analysis. Musculoskeletal Care. Accessed from: https://www.ncbi.nlm.nih.gov/pubmed/23300142
https://www.care2.com/greenliving/9-physical-symptoms-of-depression.html
https://www.tree.com/health/pain-types-psychogenic.aspx