Somatoform Pain Disorder

By Penny Chiasson, CRNA, BCH, CPHI

Pain is easily a $100 BILLION dollar per year industry (actually, that number is for ONLY back pain). And most pain specialists will tell you that the pain they are treating has no “physical cause”—meaning there was no injury leading to the pain being experienced. And as an anesthetist who provides sedation to patients undergoing non-surgical treatments in a pain center, I can confidently tell you that more than 90% of those clients I see have some form of depression, anxiety, or perceived helplessness in their history. Some days that number is almost 100%. So, what can be done about it?

Hypnosis can be a very effective treatment for somatoform pain disorders. A somatoform pain disorder is a type of psychogenic pain that is related to physical, internal or external stress. For example, you don’t normally work many hours at the computer, but you have something that must get done. You spend several hours over 2 days leaning over a keyboard, maybe bad posture plays a role. You are stressing and irritating these muscles, resulting in localized muscle tension, decreased blood flow and ultimately pain. Usually recognized as having ‘knots’ in your muscles. These are referred to as trigger points or myofascial pain syndrome or tension myositis.

Myofascial syndrome can also present from internal/external emotional stress. We become stressed and the body begins activating the internal fight or flight response. A crucial part of this response is for the body to direct blood flow to vital areas—head, heart, lungs, kidneys, liver and major muscle groups like your legs (so you can run away). As a result our head, neck and back muscles experience chronic decreased blood flow in the face of continued activity causing localized pain. At times the localized areas can set off a cascade resulting in muscle spasm. The key to reducing the discomfort is to get increased blood flow into the area. This requires countering the stress response.

While not all somatoform pain is related to emotional stress, most of it is believed to be. John Sarno, MD is pretty clear that in his experience somatoform pain that presents as myofascial pain is due to repressed rage. Years of pushing down anger, that simmering pot is using the physical body to express the rage. As we all know, emotions will find a way to get our attention if we ignore them. In this situation, 5-PATH® should be the go to in helping your client find relief from their discomfort. No matter the technique used, the client should be taught how stress affects the body’s chemical response resulting in their pain and techniques such as the relaxing breath, or meditation to counteract this response in the future.