Musculoskeletal Chronic Pain and Psychosocial Stress

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  • Murakami Masato
    Devision of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital
  • Matsuno Toshio
    Devision of Psychology, Department of Liberal Education, Nihon University School of Medicine

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Other Title
  • 筋骨格系の慢性疼痛と心理社会的ストレス
  • 筋骨格系の慢性疼痛と心理社会的ストレス--心療内科における診断と治療
  • キンコッカクケイ ノ マンセイ トウツウ ト シンリ シャカイテキ ストレス シンリョウナイカ ニ オケル シンダン ト チリョウ
  • ―心療内科における診断と治療―
  • -Psychosomatic Diagnosis and Treatment of Chronic Pain-

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Abstract

There are many patients with chronic pain who are referred from each of the clinical fields to the department of psychosomatic medicine. Various psychosocial stress factors participate in the onset of chronic pain. Psychological symptoms, such as anxiety, anger, depression, hypersensitivity, or irritation, are often related to the onset of chronic pain and change the state of illness. Chronic pain of the musculoskeletal system is often a pathologic reaction against the stress. Because a correlation between physical symptoms and psychological stress factors has been observed, chronic pain can be regarded as a representative form of psychosomatic disease. To improve efficacy in the medical treatment or psychotherapy, it is important to understand the psychosocial condition of chronic pain through sufficient history taking or appropriate psychological tests. For the pharmacological treatment of such chronic pain modified with psychosomatic factors, antianxiety drugs, antidepressants or anticonvulsants may be more effective than general analgesics or physical therapy. Holistic and specialized approaches, such as cognitive therapy or behavioral therapy, may be necessary for the treatment of chronic pain related to improper recognition, obsessive ideas or misunderstanding of the problems.

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