Somatoform disorder (patient information)
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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Associate Editor-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.
Synonyms and Keywords: Pain disorder
Overview
- Somatoform pain disorder is pain that is severe enough to disrupt a person's everyday life.
- The pain is like that of a physical disorder, but no physical cause is found. The pain is thought to be due to psychological problems.
- The pain that people with this disorder feel is real. It is not created or faked on purpose (malingering).
What are the symptoms of Somatoform disorder?
- The main symptom of somatoform pain disorder is chronic pain that lasts for several months and limits a person's work, relationships, and other activities.
- Patients are often very worried or stressed about their pain.
What causes Somatoform disorder?
- In the past, this disorder was thought to be related to emotional stress. The pain was often said to be "all in their head."
- However, patients with somatoform pain disorder seem to experience painful sensations in a way that increases their pain level. Pain and worry create a cycle that is hard to break.
- People who have a history of physical or sexual abuse are more likely to have this disorder. However, not every person with somatoform pain disorder has a history of abuse.
- As researchers learn more about the connections between the brain and body, there is more evidence that emotional well-being affects the way in which pain is perceived.
When to seek urgent medical care?
Call your health care provider if you or your child experiences chronic pain.
Diagnosis
- A thorough medical evaluation, including laboratory work and radiologic scans (MRI, CT, ultrasound, x-ray), is done to determine possible causes of the pain.
- Somatoform pain disorder is diagnosed when these tests do not reveal a clear source of the pain.
Treatment options
- Prescription and nonprescription pain medications often do not work very well. These medications also can have side effects, and may carry the risk for abuse.
- Chronic pain syndromes of all types can often be treated with antidepressants and talk therapy.
- Cognitive behavioral therapy (CBT), a kind of talk therapy, can help you deal with your pain. During therapy, you will learn:
- To recognize what seems to make the pain worse
- To develop ways of coping with the painful body sensations
- To keep yourself more active, even if you still have the pain
- Antidepressant medications also often help with both the pain and the worry surrounding the pain. Commonly used antidepressants include:
- Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro)
- Tricyclic antidepressants
- Some patients may not believe that their pain is connected to emotional factors and may refuse these treatments.
- Supportive measures that also can be helpful include:
- Distraction techniques
- Hot and cold packs
- Hypnosis
- Massage
- Physical therapy
- Stress reduction exercises
Where to find medical care for Somatoform disorder?
[Directions to Hospitals Treating Somatoform disorder
What to expect (Outlook/Prognosis)?
- The outlook is worse for patients who have had symptoms for a long time. Your outlook will improve if you can start doing your previous activities, even with the pain.
- Seeking out a mental health professional who has experience treating people with chronic pain has been shown to improve outcomes.
Possible complications
- Addiction to prescription pain medications (if they are not used correctly)
- Complications from surgery
- Depression and anxiety
Support groups
People with this disorder may benefit from treatment at pain centers.