Pain disorder

Many physical activites such as sports, pelvic surgery, etc can all contribute to PN
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river133
Posts: 260
Joined: Sun Sep 19, 2010 9:29 pm
Location: Melrose. Mn.

Pain disorder

Post by river133 »

Has anyone ever heard of, or had been diagnosed with pain disorder along with PNE? Maybe after surgery, if pain still persists? Just curious?
Surgery Jan.05 2011 TG with Dr Antalok. Dr.Chambi May of 2012 showed injury from a fall on back, 11 years ago. My piriformis muscle caused a large amount of fibrosis .My sciatic nerve was growing through the piriformis muscle which caused a bifid p.muscle. . Dr Chambi decompressed the sciatic,pudendal,pfcn ,and peroneal nerves. I hope to have a nuerostimulator put in to help with the sciatic pain that never goes away. Most days are better with the pudendal if I do not sit at all.
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Violet M
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Re: Pain disorder

Post by Violet M »

Haven't heard of it but here's an article about it.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001920/

A.D.A.M. Medical Encyclopedia.
Somatoform pain disorder
Pain disorder

Last reviewed: August 9, 2010.

Somatoform pain disorder is pain that is severe enough to disrupt a person's everyday life.

The pain is like that of a physical disorder, but no physical cause is found. The pain is thought to be due to psychological problems.

The pain that people with this disorder feel is real. It is not created or faked on purpose (malingering).
Causes, incidence, and risk factors

In the past, this disorder was thought to be related to emotional stress. The pain was often said to be "all in their head."

However, patients with somatoform pain disorder seem to experience painful sensations in a way that increases their pain level. Pain and worry create a cycle that is hard to break.

People who have a history of physical or sexual abuse are more likely to have this disorder. However, not every person with somatoform pain disorder has a history of abuse.

As researchers learn more about the connections between the brain and body, there is more evidence that emotional well-being affects the way in which pain is perceived.
Symptoms

The main symptom of somatoform pain disorder is chronic pain that lasts for several months and limits a person's work, relationships, and other activities.

Patients are often very worried or stressed about their pain.
Signs and tests

A thorough medical evaluation, including laboratory work and radiologic scans (MRI, CT, ultrasound, x-ray), is done to determine possible causes of the pain.

Somatoform pain disorder is diagnosed when these tests do not reveal a clear source of the pain.
Treatment

Prescription and nonprescription pain medications often do not work very well. These medications also can have side effects, and may carry the risk for abuse.

Chronic pain syndromes of all types can often be treated with antidepressants and talk therapy.

Cognitive behavioral therapy (CBT), a kind of talk therapy, can help you deal with your pain. During therapy, you will learn:

To recognize what seems to make the pain worse

To develop ways of coping with the painful body sensations

To keep yourself more active, even if you still have the pain

Antidepressant medications also often help with both the pain and the worry surrounding the pain. Commonly used antidepressants include:

Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro)

Tricyclic antidepressants

Some patients may not believe that their pain is connected to emotional factors and may refuse these treatments.

Supportive measures that also can be helpful include:

Distraction techniques

Hot and cold packs

Hypnosis

Massage

Physical therapy

Stress reduction exercises

Support Groups

People with this disorder may benefit from treatment at pain centers.
Expectations (prognosis)

The outlook is worse for patients who have had symptoms for a long time. Your outlook will improve if you can start doing your previous activities, even with the pain.

Seeking out a mental health professional who has experience treating people with chronic pain has been shown to improve outcomes.
Complications

Addiction to prescription pain medications (if they are not used correctly)

Complications from surgery

Depression and anxiety

Calling your health care provider

Call your health care provider if you or your child experiences chronic pain.
References

Greenberg DB, Braun IM, Cassem NH. Functional somatic symptoms and somatoform disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederamn J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 24.
Witthöft M, Hiller W. Psychological approaches to origins and treatments of somatoform disorders. Annu Rev Clin Psychol. 2010;6:257-283.
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
river133
Posts: 260
Joined: Sun Sep 19, 2010 9:29 pm
Location: Melrose. Mn.

Re: Pain disorder

Post by river133 »

Thanks for your response Violet.. My daughter and grandaughter shot these questions at me... Jus tthought I would throw it out there.. TO LET THEM KNOW THAT IS NOT THE CASE WITH ME or anyone with pne...
Surgery Jan.05 2011 TG with Dr Antalok. Dr.Chambi May of 2012 showed injury from a fall on back, 11 years ago. My piriformis muscle caused a large amount of fibrosis .My sciatic nerve was growing through the piriformis muscle which caused a bifid p.muscle. . Dr Chambi decompressed the sciatic,pudendal,pfcn ,and peroneal nerves. I hope to have a nuerostimulator put in to help with the sciatic pain that never goes away. Most days are better with the pudendal if I do not sit at all.
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Violet M
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Re: Pain disorder

Post by Violet M »

River, I think the name "pain disorder" sounds like sort of a cop-out diagnosis. It tells you nothing about what's causing the pain but it gives the doc a name he can use so it sounds like you have a diagnosis even though they haven't really figured out what's wrong. Right? What do you think?
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
river133
Posts: 260
Joined: Sun Sep 19, 2010 9:29 pm
Location: Melrose. Mn.

Re: Pain disorder

Post by river133 »

I agree totally with you Violet about this pain disorder thing.... I found myself being defensive, my husband said to me ,"why do you have to defend yourself"? He is right and so is your comment about this...
.. I want to take this time to thank you for moderating, in fact all of the moderators on this site.. You have taught me so mcuh , have taken the time to be so kind and considerate ,Your knowledge about this disease is extensive . :)
Surgery Jan.05 2011 TG with Dr Antalok. Dr.Chambi May of 2012 showed injury from a fall on back, 11 years ago. My piriformis muscle caused a large amount of fibrosis .My sciatic nerve was growing through the piriformis muscle which caused a bifid p.muscle. . Dr Chambi decompressed the sciatic,pudendal,pfcn ,and peroneal nerves. I hope to have a nuerostimulator put in to help with the sciatic pain that never goes away. Most days are better with the pudendal if I do not sit at all.
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kia kaha
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Re: Pain disorder

Post by kia kaha »

Is saying you have this pain disorder, the same as being diagnosed with 'neuropathic pain'?

As this is what I am having jammed down my throat at the moment.
My diagnosis, full stop, end of story, is Neuropathic Pain.

To me in my understanding this is just an umbrella term.
Same as saying you have Cancer, but what part of your body? what causing it?

I read somewhere on this site a very long post and near the end it said
The proper approach to neuropathic pain is a stepped program that is guided (by an interdisciplinary team approach) towards (1) identifying the etiology (2) continuing to rule out a malignant or life threatening pathology that may hide in the maze of neuropathic pain (3) lifestyle modifications (4) physical and occupational therapies (5) psychological assessment and reassessment (6) an evidence based approach to medications for neuropathic pain.
so #1 identifying the etiology, defined as
Etiology: The study of the causes. For example, of a disorder.
The word "etiology" is mainly used in medicine, where it is the science that deals with the causes or origin of disease, the factors which produce or predispose toward a certain disease or disorder.

So in summary I would expect the cause of the neuropathic pain would be sought, and 'treated' in accordance with appropriate treatments. eg: pelvic relaxing not strengthening.

Instead i am getting prescribed stronger meds and being told to take them for 1-2 years so my brain/spine forgets about the pain messages and everything goes back to normal. No therapy, support, or anything else.
But if there is a compression or entrapment, it won't make a different, as the aggravator is still there untreated, and the pain is maked, so you can make the entrapment/compression worse.

AM I RIGHT?
if not dish it out to me, but I really want to know.
Chronic Pain pudendal area for 3 years, after a hard jolt to right side.
18 months later discovered sprained/fused sacro-illiac injury. Told to 'live with it' then saw this forum October 2011 = symptoms matched. Attempting to get this investigated in the face of lack of skilled docs in New Zealand.
Been told I have IC Dec 2011
FINALLY - 3T MRI in Christchurch 5th May 2012 - Pudendal nerve block, unguided 8th June 2012 - still waiting on results and progress from these.
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Karyn
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Re: Pain disorder

Post by Karyn »

kia kaha wrote:But if there is a compression or entrapment, it won't make a different, as the aggravator is still there untreated, and the pain is maked, so you can make the entrapment/compression worse.

AM I RIGHT?
if not dish it out to me, but I really want to know.
I don't think you're wrong, Kia. Key word: UNTREATED.
Violet M wrote:River, I think the name "pain disorder" sounds like sort of a cop-out diagnosis. It tells you nothing about what's causing the pain but it gives the doc a name he can use so it sounds like you have a diagnosis even though they haven't really figured out what's wrong.
I agree.
I can't speak for anyone else, but I do know that MY anxiety comes not from the pain, but from being bounced from Dr. to Dr. with no answers in sight. Offering me psych meds isn't a viable treatment. My problem is physical. Not chemical.
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
RachelJ
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Re: Pain disorder

Post by RachelJ »

Violet M wrote:
Somatoform pain disorder is diagnosed when these tests do not reveal a clear source of the pain.
This is the part that concerns me. It does sound like it's something that will allow the doctor to give up in pinpointing one's pain and the correct treatment. Most of the treatments for this pain disorder seem to mask the pain or teach the patient to ignore the pain as opposed to reducing or getting rid of the pain.
Rachel - diagnosed in 2010 possibly as a result of labor, looking for short term medical insurance Texas that will cover me
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