Psychological and Psychiatric Aspects of Chronic Pain

Abstract

Therefore, since you do not know of the existence of a problem, you would never look for it. If these antecedent statements seems unduly arrogant, please consider how many people in the medical community are familiar with the medical diagnoses of cluneal nerve entrapment, [1], rotatory subluxation [2] odontoid fracture [3], pyrifomis syndrome [4], Hashimoto's thyroiditis [5], neuropathies due to Lymes disease and syphilis [6], tarsal tunnel syndrome [7], thoracic outlet syndrome [8,9], Eagle's syndrome [10], facial pain due to Sjoren's syndrome [10], glossopharyngeal neuralgia [10], cervical angina [11], C 2 entrapment syndrome [12], slipping rib syndrome [8], anteriolysthesis [13], retrolysthesis [13], and internal disc disruption [14], to name a few of the most often overlooked medical disorders. Compounding these commonly missed disorders, how many physicians would know the correct medical test needed to document the presence of these disorders? Therefore, it is incumbent on any clinician involved in the evaluation of chronic pain patients to be an expert medical diagnostician. Without that approach, it is easy to fall into the trap of blaming the patient for not getting well, instead of addressing the issue of misdiagnosis. The best way to study pain is to evaluate a normal response to pain, and then determine if patient deviates from this expected norm. This rationale is applied to medicine in general, since students study anatomy, so they can recognize what normal tissue looks like, in order to appreciate what is abnormal, when they study pathology.