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To all: I was talking to another Physiotherapist today about an article I read in Postgraduate Medicine by Hadler entitled “Fibromyalgia, chronic fatigue, and other iatrogenic diagnostic algorithms - Do some labels escalate illness in vulnerable patients?” The article stated that syndromes such as fibromyalgia might primarily be psychogenic. I thought that was a fair statement bound for controversy, and it definitely caused this other Physiotherapist inferring that fibromyalgia and CFS were purely psychogenic pain. He was quite insulted and angry since his wife has CFS, and he thought I was saying his wife “made up her symptoms.” I knew the above was more of a communication error between myself and this other Physiotherapist. However while I was driving home, I thought to myself, what is wrong with psychogenic pain? In essence, pain is a very subjective experience and an element of mental processing must be involved. Why is there a kind of stigma towards psychogenic pain? Why do people feel insulted or offended through the pure mentioning of this “p” word? Psychogenic pain almost has similar “offending power” as the word placebo (and notice how they all start with the letter “p”). All I have are questions: Is it simply the word psychogenic, meaning generated from the mind? Is it that we under the medical model are so focused on finding the source of the pain, the issues in the tissues, that we have ignored the contributing psychosocial factors? Is it that psychogenic pain comes with the labels such as crazy, demented and hypochondriac? Or is it that with the rapid increase of litigation and work related injuries, to have “pain coming from the mind” is viewed as being a fake, a fraud, somebody who is just there for the money? any thoughts or comments?? Henry*** _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp