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Pain Disorder

The striking feature of pain disorder is a persistent complaint of pain. The pain is the patient's major complaint, is sufficiently severe to warrant clinical attention, and significantly impairs social, occupational, or other important areas of functioning. Psychological factors playa significant role in the onset, severity, exacerbation, or maintenance of the pain. The patient doesn't intentionally produce or feign the pain. Women experience certain forms of pain such as chronic headaches more than men.

Causes

The pain may be related to psychological factors, medical conditions, or both. When the pain results from a general medical condition, it isn't considered a mental disorder (pain disorder) and is coded on Axis III ­general medical conditions.

Symptoms

The primary symptom of pain disorder is chronic pain for several months that limits a person's social, occupational, or recreational abilities.

Treatment

In pain disorder, treatment aims to ease the pain and help the patient live with it. Treatment at a comprehensive pain center may be helpful. Supportive measures for pain relief may include hot or cold packs, physical therapy, distraction techniques, and cutaneous stimulation with massage or transcutaneous electrical nerve stimulation. Measures to reduce the patient's anxiety also may help.

A continuing, supportive relationship with an understanding health care professional is essential for effective management; regularly scheduled follow-up appointments are helpful.

Analgesics become an issue because the patient believes that he has to "fight to be taken seriously." The patient should clearly be told which medication he'll receive in addition to supportive pain-relief measures. Regularly scheduled analgesic doses can be more effective than scheduling medication as needed. Regular doses combat pain by reducing the patient's anxiety about asking for medication, and they eliminate unnecessary confrontations. The use of placebos will destroy trust when the patient discovers deceit.


 

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