Somatoform pain disorder

Chronic pain is common; it is found in up to 15% of randomly selected population samples, and psychosocial factors including those provoked by physical trauma associated with industrial and motor vehicular accidents are very common in etiology. The diagnosis of post-traumatic stress disorder may be appropriate in many of these cases. The objectives of this paper are to review the psychological and social factors which contribute to the etiology of chronic pain syndromes. It reviews also the relationship of pain to Depressive, Anxiety and Substance Abuse Disorders and the principles of management of Pain Disorder. Supportive psychotherapy, pharmacotherapy (in particular tricyclic antidepressant medication) and behavioral rehabilitation programs may all be helpful in producing symptomatic improvement. An interdisciplinary pain clinic, particularly one which involves non-medical health professionals such as psychologists, social workers, occupational therapists and physiotherapists are very helpful in the management of complex cases.