Henry,
How are you mate. Good to talk again. I think you are learning very rapidly!!
You are, in my opinion (and others may differ) absolutely correct. People have this impression that pain is 90% physiological and 10% psychological. I would suggest is it more the other way around in some instances - well many infact.
I wonder if anyone has observed the social status of many patients with these syndromes. I have. It seems that many have had major family traumas such as deaths, abuse, divorce etc. that frequently they have not resolved. How did I find that out? Well, I listen intently to everything my patients tell me, and then I guide the conversation to allow them to voluntarily expand if they wish. It's amazing how people talk about what is on their mind. This will often reveal an underlying anxiety. In saying that is has been suggested that FM or CFS are viral induced. I don't think there is any proof either way. I doubt that it is all psychological. I think perhaps the condition is physiological but its severity is psychological.
---
Scott Epsley
BPhty., MAPA, SPG.
PRINCIPAL PHYSIOTHERAPIST
Clifford Chambers Sports Medicine
Suite 4, 120 Russell Street
Toowoomba QLD 4350
Australia
e-mail: [log in to unmask]
On Mon, 13 Aug 2001 20:59:11
Henry Tsao wrote:
>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***
>
>
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