What Is Psychogenic Pain?

Mental health and physical health have a close relationship. Poor mental health, such as post-traumatic stress disorder (PTSD), anxiety, and depression, can contribute to numerous physical symptoms, including psychogenic pain. Although it may not have a direct physical cause, psychogenic pain is very real and can be debilitating.

‘Psychogenic’ comes from two Greek words that mean ‘produced in the mind’, initially thought to mean imaginary pain. However, this pain can be intense, and some practitioners do not use the term psychogenic pain as it may be stigmatizing. 

How Pain Works

The body reacts and processes pain via nerves in the body. The brain has no pain receptors, so it relies on other senses to detect harm. When the body is damaged, for example, from an accidental burn, it triggers the release of chemicals into the surrounding tissue. The nervous system then detects pain via specialized nociceptors, sending pain signals to the brain. 

The brain then translates these signals into physical pain and maps the feeling to the area that hurts. The pain then triggers reflexes to move away from the source of pain, such as a hot stove. The nociceptors that receive pain signals also trigger immune responses within the body to protect the wound from infections and to begin healing. 

Pain can still be felt, even without signals from nociceptors. Nociceptors can also be activated on their own, which can cause pain without any external stimuli. Types of psychogenic pain include:

  • Headaches
  • Muscles pains 
  • Stomach aches 
  • Back pain 

The body and the brain are intimately linked. Mental health conditions can contribute to physical health conditions and vice versa. Pain is no exception – it can worsen mental health, and poor mental health can contribute to chronic pain that does not have a single source. 

Cause of Psychogenic Pain

Psychogenic pain has multiple causes, and there are many influences that dictate how people feel pain and how it affects them, such as:

  • Environment – where people are and what is happening around them can significantly impact how they feel pain. In an environment associated with pain, people can feel heightened pain levels. 
  • Mental health – negative emotions and pain are associated with the same brain parts. When people are anxious or depressed, those areas of the pain are much more active, making it easier to feel more intense.
  • Biology – genetics and previous injuries influence how people feel pain in the present day. 
  • Past traumatic experiences – trauma can influence the nervous system, making it more active as it constantly searches for threats. This can make people more susceptible to pain, and they may feel it more intensely or often.

These factors can accumulate, and the more that people are affected, the higher the chance of being impacted by different forms of pain. For example, those with a history of childhood trauma are at a much higher risk of developing chronic pain.1 The Institute for Chronic Pain reports that around 76% of those with chronic back pain have experienced trauma in the past. 66% of women with chronic headaches also reported a history of physical and sexual abuse.2 

Addressing Psychogenic Pain

When people are suffering from unexplained pain, a physician will often perform exams or tests to determine whether there is a medical or physical cause for the pain. With psychogenic pain, there are often no physical findings to demonstrate what is causing it, and the physician may take an alternative route to determine a treatment approach. 

It can take a long time to understand if they are suffering from psychogenic pain. They may spend a lot of time trying different doctors to determine the cause of their pain and can even resort to strong painkillers to manage their symptoms. This can lead to substance abuse and dependency. 

Although it can be a challenge, psychogenic pain can be addressed and treated by a mix of physical and mental health modalities, including:

  • Group therapy – group therapy provides a space for people struggling with pain to share their experiences with others who are going through a similar thing. Attendees can share ideas and information with one another and provide support while addressing chronic pain and its potential causes of it. 
  • Physical therapy – psychogenic pain can cause physical effects such as muscle pain and tension. Physical therapy and regular exercise can help to address these symptoms and treat physical discomfort. 
  • Medication – psychogenic pain can often co-occur with mental health conditions such as anxiety, depression, and PTSD. Medication addressing these conditions can help people manage their pain better and potentially lessen their symptoms. Non-narcotic painkillers such as ibuprofen may also be prescribed to help people manage intense pain. 

Psychogenic pain can be severe, although it is not as well understood as other forms of pain. However, it is treatable, and with a combination of medical interventions and psychotherapy, this pain can be addressed. 

Sources:

[1] Schofferman, J., Anderson, D., Hines, R., Smith, G., & Keane, G. (1993). Childhood psychological trauma and chronic refractory low-back pain. The Clinical Journal of Pain, 9, 260-265.

[2] Domino, J. V., & Haber, J. D. (1987). Prior physical and sexual abuse in women with chronic headache: Clinical correlates. The Journal of Head and Face Pain, 27, 310-314.

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