THE TRUTH ABOUT PSYCHOSOMATIC PAIN- A PSYCHIATRIST’S

THE TRUTH ABOUT PSYCHOSOMATIC PAIN- A PSYCHIATRIST’S

PERSPECTIVE

A large population of people who visit, approximately 30-40%, an orthopaedics clinic or physiotherapy have a strong psychosomatic component. Your mind and body are connected. Stress, anxiety,
depression can be the causes behind the “CHRONIC PAIN”, the “DISPROPOTIONATE PAIN”, the pain which is also associated with other symptoms like – Feeling always tired, headaches/migraines frequently, palpitations, sleep at times, disturbances, feeling sad and anxious all the while.

These Psychosomatic components also delay the recovery post-surgery and limit the general functionality of the individual. Among such physical symptoms, are mainly influenced by our thoughts, emotions, and stress levels.

Listing the types of psychosomatic disorders as per
DSM-5:

1. Somatoform Disorder
   Having 1 or more disturbing physical
   symptoms
   Spending a lot of time and energy troubling
   about them
   Multiple doctor visits with no clear cause
   detected
   Pain that keeps on recurring

2. ILLNESS ANXIETY DISORDER
   Excessive fear of a serious disorder
   Fear is more than the symptom itself.
   Repeated reassurance tests.
   Thoughts for a “simple backpain” like –
   What if it is a tumor? What if it is permanent damage? If so, will it spread to my
   whole body?

3. FUNCTIONAL NEUROLOGICAL SYMPTOM DISORDER
   These symptoms simulate a nerve or a brain
   problem, it can be related to a psychosocial stress factor.
   Sudden weakness
   Fainting spells
   Difficulty walking
   Non-epileptic seizure

What are some neurochemical causes for Psychosomatic pain?

1. LOW SEROTONIN – can lead to sharper
   perception of pain, slower recovery from injury and dysregulated pain signals
   to the brain

2. GLUTAMATE – This is an excitatory neurotransmitter
   characterized by becoming hyperactive in chronic stress and emotional overload.

3. STRESS HORMONES – CORTISOL AND ADRENALINE – When
   these two are released it leads to increase in joint inflammation and tightening
   of muscles.

4. DOPAMINE REDUCTION – It reduces the motivation level
   and pain tolerance. Common in Depression and chronic stress.

How do we treat Psychosomatic complaints?

1. Ruling out structural problems, assisted by orthopaedics.

2. Error correction by LIFESTYLE SUPPORT

• Sleep hygiene

• Nutritional support (removing the food
  that elevates the body’s inflammation level)

• Relaxation techniques

• Guided physiotherapy

3. Treatment of underlying Anxiety, Depression with
   drugs and counseling when necessary.

Your “PAIN” needs a team to heal. With proper mental health support, the recovery is quicker, smoother, and more sustainable.