Hysterical paralysis in the upper extremity of chronic pain patients

The patient with chronic pain who develops the conversion symptom of hysterical paralysis in the upper extremity can be treated successfully by rehabilitation medicine services, using a shaping behavioral program. Four case reports illustrate the management of this condition and the basic ingredients for such a program are outlined. The approach is based upon learning principles and experience with conversion reactions affecting gait. Treatment outcome often is related directly to the care and skill with which psychological assessment is performed and to the coordinated effort of the various team members.