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Psychogenic Pain


JJenny Andrusenny L. F. Andrus, MD

“Psychogenic pain” is pain that doesn’t have a directly attributable physical cause, like a broken bone or a cut on a finger.  There is no distinguishable reason for the pain to exist, but it is there, nonetheless. The person describing the pain has suffered no illness, no injury or cause for the pain, other than the pain arising from the brain and being felt by the person in the body.

“Psychogenic pain” is a way of describing pain that has fallen out of favor with clinicians, due to the negative connotations attached to this term.  The two Greek root words for psychogenic mean “created in the mind”.  Add that to the word “pain” and you get “pain that is created in the mind”.  It isn’t too much of a stretch to understand why some might find this term distasteful at first glance.  However, let’s take a closer look at where pain originates – the brain – and understand the complex factors that can impact its severity, including existing health conditions, mental and emotional states, family history, environmental factors, and more.

Although clinicians don’t understand why psychogenic pain occurs, we do know that the pain is real, and isn’t imaginary or faked.  The patient can exhibit the same behavioral (blinking, wincing, frowning, guarding) and autonomic signs (increased BP, HR, and respiration) as the patient who has suffered a painful injury or illness.

If a patient comes to see me at OSC Pain Management, they must be referred by another physician who has already seen them for a basic evaluation for their pain.  At that point, I will get to play detective and review the patient’s past medical notes and medical history and see if I can discern what may be causing the pain they are experiencing.  A thorough examination and tons of questions will also be asked by me to get a better understanding of the patient, who they are and what their life is like.  This helps me put together the best diagnosis, based on their painful symptoms and the information they give me.

Researchers are learning more about pain and the brain every day, but there is still much to learn.  Physicians used to treat pain very differently than they do now.  Now, we know that we must consider the entire human being, their physical health, emotional, behavioral, and social well-being and address each component as a part of a complex individual.  This is a tall order for most MDs to accomplish in an office visit, so at OSC, we have a Clinical Psychologist, Dr. Andrew Martin, on our team, to provide the emotional and behavioral support needed for the comprehensive treatment of pain for our patients.

I typically provide a multi-faceted approach to pain management (without narcotics) that looks at the well-being of my patient as a whole person.  I want to provide medications, only as necessary, to bring about healing and relief of pain.  I’m a big believer in good nutrition, gentle exercise, plenty of good sleep and rest while we relieve your painful symptoms.   I also encourage my patients to seek emotional support from Dr. Martin while healing.  If we can accomplish those goals, we usually can turn things around for the better within a few months. Whether I can pinpoint a physical reason for your pain or not, my therapeutic recommendations for my patients are pretty much the same – let’s heal all of you, safely, so you can live your best life.







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