Somatoform pain disorder

• Alternative Names

  Pain disorder

• Causes, incidence, and risk factors

  Pain is one of the most common reasons why people seek medical attention. In somatoform pain disorder, the pain is so severe that it impairs a person's ability to function.

  The pain in this condition is thought to be related to psychological factors, such as stress. People with this illness may have other medical problems, but these do not fully explain the pain.

  There is a stigma about psychological pain by medical professionals and the general public. Some people do not fully understand the connection between mind and body. They mistakenly believe that psychological pain isn't "real" and should be able to be controlled without medical or mental health treatment.

• Symptoms

  The main symptom of pain disorder is chronic pain that lasts for several months and limits a person's work, relationships, and other activities.

• Signs and tests

  A thorough medical evaluation, including laboratory work, is done to determine possible causes of the pain.

• Treatment

  Some patients may not believe that their pain is due to psychological factors, and may refuse treatment by a mental health professional. Yet many chronic pain syndromes, including those due to physical problems, 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 nonprescription pain medications are usually not effective and can have serious side effects.

• Support Groups

  People with this disorder may benefit from treatment at pain centers.

• Expectations (prognosis)

  The outlook is worse for patients who have had symptoms for a long time. Your outlook will improve if you can start doing your previous activities, even with the pain.

• Complications
  • Addiction to prescription pain medications (if they are not used correctly)
  • Complications from surgery
• Calling your health care provider

  Call your health care provider if you or your child experiences chronic pain.

• References

  DeGruy FV. The somatic patient. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 61.

  Purcell TB. Somatoform disorders. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006:chap 111.

Review Date: 8/24/2008

Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.