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Related Experiment Videos

Low back pain and illness behavior (inappropriate, maladaptive, or abnormal)

I Pilowsky1

  • 1Pain Service, Royal Adelaide Hospital, South Australia.

Spine
|July 1, 1995
PubMed
Summary

Patients with low back pain lacking a clear physical cause may be mislabeled. The concept of "abnormal illness behavior" helps clarify diagnosis and management, highlighting the doctor's role.

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Area of Science:

  • Medical diagnosis
  • Psychosomatic medicine
  • Patient behavior

Background:

  • Low back pain without identifiable physical cause often leads to misdiagnosis.
  • Labels like "hysteria" and "hypochondriasis" are sometimes applied based on exclusion.
  • The physician's role in patient interaction is critical in these cases.

Purpose of the Study:

  • To introduce and clarify the concept of "abnormal illness behavior."
  • To improve classification and diagnosis of patients with unexplained low back pain.
  • To discuss principles of management for these conditions.

Main Methods:

  • Conceptual analysis of diagnostic and management approaches.
  • Review of clinical scenarios involving patients with unexplained pain.

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  • Discussion of the physician's influence on patient perception and behavior.

    • Main Results:

    • The concept of "abnormal illness behavior" provides a framework for understanding these complex cases.
    • Diagnosis is often based on exclusion, necessitating a refined approach.
    • Physician behavior significantly impacts patient outcomes.

    Conclusions:

    • "Abnormal illness behavior" offers a more precise way to classify and diagnose patients with unexplained low back pain.
    • Effective management requires attention to the physician-patient dynamic.
    • Further research into physician communication and patient education is warranted.