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Related Experiment Videos

[Chronic, unexplained pain: from complaint to action].

J van Gijn1, W F Bierman, C Zuketto

  • 1Universitair Medisch Centrum, afd. Neurologie, Utrecht.

Nederlands Tijdschrift Voor Geneeskunde
|April 25, 2000
PubMed
Summary

Physicians often struggle with unexplained chronic pain. Reassurance and gradual activity programs can help patients manage these symptoms, with about half showing improvement.

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Area of Science:

  • Neurology
  • Psychosomatic Medicine

Background:

  • Medical education inadequately prepares physicians for managing patients with unexplained physical symptoms.
  • Specialists frequently experience helplessness, leading to increased referrals and unnecessary surgical interventions.

Observation:

  • Three patients with chronic, unexplained pain (back, neck, arm) presented for neurological consultation.
  • Patients exhibited no clear signs of depression, and their symptoms persisted for years.
  • A neurologist provided reassurance and prescribed a structured, gradually increasing activity program.

Findings:

  • The intervention led to a reversal of illness behavior in the three initial patients.
  • Follow-up with 27 similar patients indicated success in approximately 50% of cases.
  • No specific predictive factors were identified at baseline, apart from patient age and symptom duration.

Implications:

  • Unqualified recognition and reassurance are crucial first steps in managing unexplained chronic pain.
  • An explanatory model that avoids a mind-body dichotomy is essential for effective patient care.
  • This approach offers a potential strategy for improving outcomes in patients with functional somatic symptoms.

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