Functionalvs. organic pain: A meaningful distinction?

Abstract

This study examined the statistical and clinical validity of the distinction frequently made between “functional” pain and “real” pain. Earlier work has relied on the MMPI exclusively and results have been inconclusive, yet the distinction continues to be made and treatment is recommended on the basis of the label. Sixty‐seven chronic back pain patients were administered questionnaires that assessed quantity and quality of depression, dimensions of illness behavior, and psychogenic attiudes. Scores of chronic pain patients were compared to normal subjects, and results indicate that the pain subjects experience high levels of depression, anxiety, and social alienation. However, organic pain subjects did not differ from subjects with no organic findings. The authors suggest that the distinction between organic and functional pain be discarded in favor of an approach that assesses current emotional stressors and available coping mechanisms.

Psychosocial correlates of recurrent childhood pain: A comparison of pediatric patients with recurrent abdominal pain, organic illness, and psychiatric disorders.

“…In contrast to these differences in RAP patients in comparison with well children and psychiatric patients, there were no differences between RAP patients and patients with peptic disease on measures of emotional distress, somatic complaints, or functional disability. This findings is consistent with evidence that adult patients with and without organic diagnoses for gastrointestinal and other complaints tend to have similar elevations on measures of psychological distress, somatization, and illness behavior (Smith et al, 1990; Trief, Elliott, Stein, & Frederickson, 1987). The present data do not permit inferences regarding the extent to which psychological distress may be a cause or consequence of recurrent abdominal pain and peptic disease or whether the processes leading to psychological distress may differ for the two diagnostic groups.…”

Is scoliosis a source of pain?

“…The original distinction between functional and organic pain has now become meaningless, and several specialists from different horizons have concentrated their efforts to better understand and apprehender it. 1 In scoliosis patients, muscle dysfunction, concave disk pressure, asymmetrical facet joint strains, and high body mass index (BMI) are the main mechanical parameters incriminated, but the analysis of the role of anxiety and self-perception has recently gained popularity. 2 The literature remains controversial to date and not sufficiently clinically relevant for the pediatric surgeons who have to manage these patients.…”