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.

How to recognize and manage psychosomatic pain in the pediatric emergency department

Aim Children and adolescents affected by somatization and somatic symptom disorder commonly refer to emergency services. Due to the absence of specific guidelines for the emergency setting and to a possible lack of knowledge, these patients are at risk of being unrecognized and mismanaged. This study aims at proposing a clinical practice to approach and manage these patients and their families in the emergency setting. Methods This manuscript derived from the work of a research group of italian pediatric emergency physicians and anesthesiologists, with an expertise in pain management, members of the PIPER group. The research group reviewed the literature about psychosomatic pain and somatic symptom disorder and developed a clinical practice specific for the pediatric emergency setting. Results The manuscript provides information about the main clinical features shared by patients with psychosomatic pain and about current diagnostic criteria and appropriate management in the emergency setting. Furthermore, it highlights the possible pitfalls in which the emergency physician may run into dealing with these patients. Conclusion This clinical practice should be seen as a starting point toward a better understanding of patients with psychosomatic pain and a standardization of care in the pediatric emergency setting.

How to Recognize and Manage Psychosomatic Pain in the Pediatric Emergency Department

Aim: Children and adolescents affected by somatization and somatic symptom disorder commonly refer to emergency services. Due to the absence of specific guidelines for the emergency setting and to a possible lack of knowledge, these patients are at risk of being unrecognized and mismanaged. This study aims at proposing a clinical practice to approach and manage these patients and their families in the emergency setting.Methods: This manuscript derived from the work of a research group of italian pediatric emergency physicians and anesthesiologists, with an expertise in pain management, members of the PIPER group. The research group reviewed the literature about psychosomatic pain and somatic symptom disorder and developed a clinical practice specific for the pediatric emergency setting. Results: The manuscript provides information about the main clinical features shared by patients with psychosomatic pain and about current diagnostic criteria and appropriate management in the emergency setting. Furthermore, it highlights the possible pitfalls in which the emergency physician may run into dealing with these patients.Conclusion: This clinical practice should be seen as a starting point toward a better understanding of patients with psychosomatic pain and a standardization of care in the pediatric emergency setting.

Psychosomatic pain correction in patients with discogenic dorsopathies

The article discusses the psychosomatic approach to the treatment of pain syndromes in patients with discogenic dorsopathy, based on the combined use of kinesitherapy and psychological correction of anxious depression using transcranial exposure using neuroacoustic stimulation on individually rhythms and meso-encephalic modulation using magnetically and photostimulation. It was established that the treatment of pain syndromes in patients with discogenic dorsopathy based on the proposed method reduces the subjective assessment of pain on the VAS scale by almost 30 % and the level of depression by 20 % in the A. Beck psychometric table compared to the control group.

Impact of post appendectomy pain

Background: Appendectomy is one of the commonest abdominal operation performed during emergency hours for acute appendicitis. Acute appendicitis is the common pathology in right lower abdomen. Postoperative complications following appendicectomies are not uncommon and reflect the degree of peritonitis that was present at the time of operation. Intra operative spillage and intercurrent diseases that may predispose to the complication. But all patients are not relieved of their symptoms following surgery. Few patients continue to visit surgical OPD for continuous pain in right iliac fossa even after appendectomy had been performed. So, we design proforma to find out exact cause of pain. This study is a sincere effort on our part to solve secrets of post appendectomy pain.Methods: Evaluation of patient who continue to visit even after removal of appendix for pain in right iliac fossa. It was tried to establish correlation between relief of pain and histopathology report of appendix to justify the appendicectomies. These patients investigated to find out underlying organic cause. Functional patients were subjected for psychological evaluation.Results: In present study from June 2006 to August 2008 we enrolled around 30 patients with complaints of pain in right iliac fossa even after appendectomy. 60% were female and 40% were male in a present study. Out of 30 cases 24 patient means 80%, were in the age group of 20 to 40 years. We found one patient means 3.33% with clinical diagnosis of stump appendicitis on radiological (barium meal follows through) examination was confirmed who responded to conservative line of treatment. All patients presented with pain in right iliac fossa symptom was the criteria for selection of patients. Exception of single patient of stump appendicitis rest were having other treatable causes.Conclusions: Out of 30 patients only one patient was having actual stump appendicitis. It is not correct to say that post appendectomy pain is a complication of surgical procedure, as multiple treatable causes were found in 29 patients. Study demonstrated that most of these patients really had organic disease. Only two patients were simple victims of psychosomatic pain. This study enlightened nicely regarding various delayed complications of appendectomy.