Psychosomatic Pain? The Meanings of Musculoskeletal Affliction in Finnish Medicine, ca. 1950–2000

In recent decades, pain has received extensive attention from historians. However, the boundary work between organic and psychogenic pain has been less studied. To address the mind–body problem in the history of pain, this article examines how Finnish physicians in the latter half of the twentieth century have applied the psychosomatic framework to three painful conditions: rheumatoid arthritis, chronic backache and fibromyalgia. Through the interrelated case studies, it is argued that the medical discussion on musculoskeletal pain reflected social and economic interests and values that evolved in the course of the twentieth century. The psychogenic illness explanation compelled physicians to step outside the confines of biomedical rationale. Therefore, the descriptions of the ‘mind’ behind the ‘body’ render conspicuous for historians the values, moral norms and social expectations that underlie biomedicine.

Pain, depression and anxiety: is there a light at the end of the tunnel?

In the present paper a modern sights to problem of chronic psychogenic pain and its relation to depressive and anxiety disorders have been looked. Based on this point of view, the requirements to choice of optimal pharmacological tool within complex therapy of psychogenic pain, depression and anxiety have been analyzed. A main attention paid to mechanisms of action and peculiarities of clinical use of drugs: duloxetine (Revival) – antidepressant from SNRI group with unique mechanisms of action and clinico-pharmacological properties, which make possible to realize the on-time impact on the mechanisms of development of depression and psychogenic pain; and pregabaline (Ligato) – drug from the anticonvulsants group, which influenced on universal mechanisms of cell ionic permeability at anxiety disorders and psychogenic pain. A clinical efficacy of duloxetine (Revival) and pregabaline (Ligato), its safety characteristics, and recommendations of practical use have been looked in detail.

Psychogenic Pain: A Useful Concept?

The term “psychogenic” pain was use liberally during the 20th century. It has been applied in a number of different ways. First, to describe pain originating from psychological/psychiatric (ie, mental) processes. Second, as a way of declaring that, although there may be physical abnormalities, the degree of pain experienced is dictated by psychological states. Finally, to imply that psychological factors co-mingle with physical factors in the experience of pain, especially chronic pain. By its very nature, “psychogenic” implies of separation of mind and body. Most often it has been used as a diagnosis of exclusion—we cannot find the real (ie, medical/physical) cause, so it must be psychological, all but impugning the validity of the patient’s report. In the midst of modern technology and research, and the prevailing philosophical approach to pain (chronic), the term “psychogenic” has exhausted its research, clinical, and practical utility. This chapter provides supporting evidence for this conclusion and research data highlighting the complex and dynamic nature of pain (chronic).

PSYCHOLOGICAL FACTORS ASSOCIATED WITH CHRONIC OROFACIAL PAIN.

Pain is one of the most common symptoms encountered in clinical practice and the head is a frequent site of pain. Chronic Orofacial Pain (COP) represents a complex pain condition with an etiology comprised of many factors including those falling within biological, psychological, and social domains. Psychogenic regional pain is a term used for “pain that patients feel in a region of the body where no peripheral cause can be found and is psychogenic in its evocation”. Even in the field of psychology/psychiatry, many aetiologies and psychodynamics have been related to the development of psychogenic pain. This article deals with the treatment modalities to deal with the psychological repercussions of physical, orofacial pain.

Chapter 3. Mechanisms of changes in dynamic complexity of EEG patterns underlying correction of psychogenic pain in anxiety-phobic states

The third chapter explains the mechanisms for correcting anxiety-phobic states. For this, the changes occurring in the EEG patterns during the presentation of a painful stimulus and in the process of eliminating the pain sensation using the psychorelaxation technique in healthy individuals are considered; and these changes are compared with changes in EEG patterns during patients’ feelings of psychogenic pain and during its removal using psycho-relaxation techniques. It has been shown that the mechanisms underlying the correction of psychogenic pain in anxiety-phobic states are associated with changes in the dynamics of successive EEG values and the degree of their multifractality. With successful correction in the process of psychorelaxation in persons with anxiety-phobic disorders, there is a transition to the values of multifractal parameters characteristic for healthy people.