Psychosomatic pain
Keywords:
psychosomatic pain, clinics, treatmentAbstract
Somatization disorders can lead to pain that does not follow the anatomical distribution of peripheral nerves and other structures. The pain is combined with many other chronic symptoms. Anxiety and depression lower the patient's pain threshold and tolerance to it. The pain can be localized in different body areas: the face, chest, abdomen, pelvis or urogenital area. Depending on the localization of the pain, different syndromes have been described, some of which overlap.
Common syndromes are burning mouth syndrome, persistent idiopathic facial pain, atypical odontalgia, panic disorder, Munchausen syndrome, functional abdominal pain syndrome, irritable bowel syndrome, chronic pelvic pain syndrome, prostatodynia, interstitial cystitis syndrome, urethral pain syndrome, chronic generalized perineal pain syndrome, vulvodynia, clitoral pain, testicular pain, chronic idiopathic anal pain, and proctalgia fugax. The clinical course of the syndromes is characterized by continuous or intermittent pain, to which are added various symptoms associated with impaired function of the affected organ. The etiology is unclear, it is assumed to be psychosomatic, related to psychological factors. The pathogenesis of pain is related to central sensitization, impaired pain modulation and neuropathic pain. The diagnosis is made after excluding all possible neurological, local and systemic diseases of the internal organs. Clinical neurological examination and laboratory tests showed no abnormalities. In some of the syndromes, the Rome IV criteria are applied to establish the diagnosis.
Treatment of psychosomatic pain syndromes is difficult. Cognitive behavioural therapy, relaxation, biofeedback, acupuncture, botulinum toxin, anticonvulsants, and SNRI antidepressants are used.
In conclusion, pain in psychosomatic syndromes can be localized in different areas of the face and body. It has the character of chronic and neuropathic pain and is affected by medications used to treat neuropathic pain.
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