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Management of chronic myofascial pain: finding common ground
Published in Kirsti Malterud, Steinar Hunskaar, Chronic Myofascial Pain, 2018
Kirsti Malterud, Steinar Hunskaar
An exact diagnosis of the type of pain should be sought. Psychogenic pain may be present. Severe function-loss because of pain in a person with no clinical signs and concomitant denial of any psychological or social problems is suspicious, and the patient should be referred, preferably to a multidisciplinary pain clinic.
The Tao of Pain
Published in Peter Wemyss-Gorman, John D Loeser, Pain, Suffering and Healing, 2018
Whilst these factors are essential components of pain they cannot be seen in isolation from other dimensions. Yet the use of the term ‘psychogenic pain’ is still common, implying as it does a singular cause and dimension, often reflecting the clinician’s failure to cure with physical approaches (‘It must be all in the mind.’).
The Phenomenon of Chronic Pain
Published in Ronald Schleifer, Pain and Suffering, 2014
Closely associated with the problem and complexity of chronic pain is the focused attention given to neurological processes associated with the phenomena of pain in more recent years insofar as such studies have tried to describe pain in relation to other sensory systems or, alternatively, in relation to larger cognitive systems. At one extreme is the philosophical analysis of pain based upon biological materialism—that is, based upon the neuro-physiology of the brain. Hardcastle nicely articulates this position in her attempt to debunk “two myths about pain”: first, she denies that pain is a subjective state of mind; and second she denies that pain without any physiological corollary—which is sometimes called “psychopathological pains” or “psychogenic pain”—actually exists. (We can define psychogenic pain as “physical pain that is caused, augmented, or prolonged by emotional factors” [Thernstrom 2010: 140]). Both of these myths, Hardcastle argues, assume (often not fully explicitly) that there is “a pernicious dualistic mind/body distinction” in understanding the phenomenon of pain as a form of psychopathology that subscribes to the truth of the psychogenic claim that all pain is subjective. In opposition to this assumption Hardcastle argues “that all pains are physical and localizable and that all are created equal” (1999: 7).
The pharmacological management of dental pain
Published in Expert Opinion on Pharmacotherapy, 2020
Joseph V. Pergolizzi, Peter Magnusson, Jo Ann LeQuang, Christopher Gharibo, Giustino Varrassi
Psychogenic pain is not yet entirely elucidated but it refers to pain with no obvious physical cause and with no local tissue or dental damage. Psychogenic pain, which differs from malingering or fictitious reports of pain, tends to be diffuse and wanders around the body. Psychogenic toothache, like other forms of psychogenic pain, may worsen with stress and does not reliably respond to pharmacological pain treatment. In some cases, a psychiatric referral is preferable to dental treatments, which may not reduce the patient’s pain [66].
An update on the pharmacological management of pain in patients with multiple sclerosis
Published in Expert Opinion on Pharmacotherapy, 2020
Clara G. Chisari, Eleonora Sgarlata, Sebastiano Arena, Emanuele D’Amico, Simona Toscano, Francesco Patti
Psychogenic pain is typically caused or exacerbated by mental, emotional, or behavioral factors and is commonly reported by MS patients with psychiatric comorbidities as anxiety or depression. It has been widely demonstrated that mood dysfunctions and pain are closely related and their coexistence further aggravate the severity of both disorders [19]. This is particularly true as depressive symptoms are present in about a quarter of MS patients [18].
Analgesic hypnotic treatment in a post-stroke patient
Published in American Journal of Clinical Hypnosis, 2021
Caterina Formica, Katia Micchia, Emanuele Cartella, Simona De Salvo, Lilla Bonanno, Francesco Corallo, Francesca Antonia Arcadi, Roberto Giorgianni, Angela Marra, Placido Bramanti, Silvia Marino
Several scientific studies have showed how the hypnotic method could permit the recovery of patient wellness (Häuser, Hagl, Schmierer, & Hansen, 2016). An interesting consideration is that an important external stimulation, such as therapeutic hypnosis, could restore the rhythm of neurogenesis (Rossi, 2003). Other studies have demonstrated hypnosis’ efficacy on cognitive recovery (in particular, memory and patients’ learning ability). The hypnotic trance could be influenced by the “power of words” on the various sites of a genetic cascade and therefore on the subsequent phase of cerebral plasticity, determining a strong therapeutic response (Rossi & Rossi, 2006). This method has been successful in functional recovery and in patients’ quality of life. This process is justified by mirror neurons. Premotor mirror neurons, involved in empathy and understanding of intentions of others (Iacoboni et al., 2005), are now hypothesized as activators of brain plasticity through the dynamic processes of mind-body healing during approaches to therapeutic hypnosis (Gafner, 2005; Rossi, 2002). In recent years, hypnotic suggestions have also been applied to clinical conditions, anxiety treatment, somatization, and post-traumatic stress disorder. Pain is a clear manifestation of illness and usually related to a psychologic illness; for example, conversion hysteria constitutes a largest percentage of the psychogenic pain in a hysteric population (Engel, 1959). Hypnotic analgesia is one of the most clinically useful phenomenon of hypnosis. Other findings have suggested that hypnotic treatments have numerous positive effects beyond pain control (Hilgard, 1975; Hilgard, 1975; Heap, 1995). Neurophysiological studies reveal that hypnotic analgesia has clear effects on the brain and offer information about physiological mechanisms of hypnotic analgesia (Jensen & Patterson, 2014; Patterson & Jensen, 2003). In fact, somatosensory evoked potentials (SEPs) during analgesia highlight an improvement of N140 and N250 components. Hypnotic analgesia have led to highly significant mean reductions in perceived sensory pain and distress (Del Casale et al., 2015). Neuroimaging studies reported neural activity modulated by hypnotic suggestions (Dumont, Martin, & Broer, 2012; McGeown, Mazzoni, Venneri, & Kirsch, 2009). Some evidence has indicated that suggestions of hypnotic analgesia decreased the functional activity in certain areas of the pain matrix.