What are the other Names for this Condition? (Also known as/Synonyms)

• Psychogenic Pain Disorder
• Somatoform Pain Disorder

What is Pain Disorder? (Definition/Background Information)

• Pain Disorder is a mental disorder in which individuals experience physical pain that is associated with psychological stress. The severity of the pain may last anytime between a few days to many years, and can severely disrupt one’s daily life and routine
• Pain Disorder falls into the category of somatic disorders, which are disorders that cause bodily symptoms, such as pain, that cannot be traced back to physical cause 
• Although many individuals may feel pain that is not connected to a physical cause, a third may feel severely distressed by Pain Disorder. The most common areas of pain are the back (especially lower back), head, abdomen, and chest
• The exact cause of Pain Disorder has not yet been identified. Both biological and environmental factors may play a role in the development of this condition
• The treatment of Pain Disorder may include a combination of psychotherapy and medication. With a consistent treatment plan and support from family and friends, most individuals can live a pain-free healthy life

Who gets Pain Disorder? (Age and Sex Distribution)

• Pain Disorder is likely to develop in adulthood; as the individuals grow older, the pain increases in frequency, which is medically unexplained
• Although both genders may be affected, it is more prevalent in females 
• Worldwide, individuals of all racial and ethnic groups may be affected

What are the Risk Factors for Pain Disorder? (Predisposing Factors)

The risk factors for Pain Disorder are as follows: 

• Family history of mental illness, such as anxiety and depression
• Family history of chronic physical illness 
• Personal history of mental illness, such as anxiety and depression
• High levels of stress

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pain Disorder? (Etiology)

The exact cause of Pain Disorder has not yet been identified, but the following biological and environmental factors may contribute to its development:

• Biological factors:
  • Family history of mental illness 
  • Family history of chronic physical illness 
• Environmental factors:
  • Stress
  • Emotional distress (physical or psychological trauma/abuse)

What are the Signs and Symptoms of Pain Disorder?

The signs and symptoms of Pain Disorder may vary in type and severity among the affected individuals and include:

• Unexplainable pain - constant pain without a physical cause
• Negative or distorted cognition - feeling helpless in regards to pain and management
• Inactivity, passivity, or disability - disruption to regular functioning
• Insomnia and fatigue - disruption of sleeping patterns
• Inability to manage relationships - either familial, social, or occupational
• Anxiety and depression

How is Pain Disorder Diagnosed?

A diagnosis of Pain Disorder may involve the following methods:

• Complete physical examination
• Comprehensive personal and family medical history evaluation 
• Laboratory tests to rule out physical factors of pain
• Imaging tests to rule out physical factors of pain
• Assessment of symptoms based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that mention that:
  • The pain is severe enough to warrant clinical attention
  • The pain causes significant distress in regular functioning
  • Psychological factors play a significant role in the pain
  • The symptoms are not intentionally displayed (faking the pain)
  • The pain is not accounted for by mood, anxiety, or psychotic disorders
• Differential diagnosis to rule-out other disorders that may present with similar signs and symptoms

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pain Disorder?

The following complications may arise as a result of Pain Disorder:

• Feelings of emotional distress and helplessness
• Being misunderstood by others (may be perceived as faking or lying about symptoms)
• Disruption to social, academic, and occupational functioning
• Difficulty in managing relationships
• Addiction to alcohol and drugs to manage pain

How is Pain Disorder Treated?

There is no known cure for Pain Disorder. The treatment for Pain Disorder addresses signs and symptoms of the condition, and may vary depending on the severity and duration of the pain. The affected individuals may be treated using a combination of the following methods:

• Psychotherapy:
  • Cognitive-behavioral therapy (CBT) to change negative and dysfunctional thought patterns, feelings, and behaviors
  • Family therapy focuses on educating the family of the disorder, as well as explain possible recurrence
  • Operant conditioning: To reinforce non-pain behaviors, to encourage regular activity and eliminate harmful behaviors such as passivity, inactivity, and reliance on medication
• Medication
  • Acetaminophen, anti-inflammatory drugs, and opioid analgesics to relieve pain
  • Antidepressants to manage mood
• Meditation and relaxing techniques: Relaxation methods, such as acupuncture, massages, and yoga, may be beneficial in bringing peace and comfort to the affected individuals and in reducing pain symptoms

How can Pain Disorder be Prevented?

Presently, no preventive methods or guidelines are available for Pain Disorder.

• Seeking professional help during chronic pain before the development of distress and disability may aid in slowing down the progression of Pain Disorder
• Active research is currently being performed to explore the possibilities for treatment and prevention of conditions such as Pain Disorders
• Regular medical screening at periodic intervals with tests and physical examinations are recommended

What is the Prognosis of Pain Disorder? (Outcomes/Resolutions)

The prognosis of Pain Disorder is dependent on the severity and duration of the signs and symptoms.

• The outcome is typically good and this disorder is not life-threatening
• Individuals with severe pain and emotional distress may have a longer treatment process
• With a consistent treatment plan and support from family members and friends, individuals can lead a healthy and wholesome life

Additional and Relevant Useful Information for Pain Disorder:

Information on cognitive behavioral therapy may be found at:

http://www.dovemed.com/current-medical-news/brain-volume-changes-after-cognitive-behavioral-therapy/ 

Information on relaxation techniques can be found at:

http://www.dovemed.com/healthy-living/wellness-center/how-lower-your-stress-levels/