Making a Back Pain Diagnosis: Psychological Tests
Psychosomatic pain, also called psychalgia, is physical pain that is caused, increased by emotional factors, such as fear, stress, and anxiety. Pain connected to emotional stress of sadness may cause pain may be connected to structural abnormalities such as back problems in complex ways. Emotional stress, while usually not the sole cause of arthritis and pain, may exacerbate the physical symptoms of medical problems, such as pain. Real medical problems may become interconnected with psychological problems to create a downward cycle for the patient, where the pain of a medical problem causes emotional stress and depression, and this anxiety amplifies the symptoms of the medical problem.
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There is some controversy in the medical and psychological field as to how much emotional stress and anxiety can contribute to physical pain and other symptoms such as muscle aches. Take the medical disorder of Fibromyalgia, for example. The rheumatologists, back specialists, and primary care doctors separate into different groups in their view of this condition. Some doctors, somewhat privately, take a more pessimistic view of the people with this disorder, considering it a "nutcase disease". The people in the "nutcase disease" group think that the people who have fibromyalgia are faking it or are experiencing Psychosomatic symptoms of depression or anxiety. The People more sympathetic to the theory that fibromyalgia has an organic component to it are more likely to try to confirm evidence of a structural or muscular problem by ordering X-Rays, blood tests, and more sophisticated blood tests for that patient.
Although psychological stresses are rarely the only cause of back pain, they can certainly exacerbate the symptoms or result from it. If you are a person who suffers from chronic pain, you know it is a medical problem/disease that can be both physically and emotionally debilitating. Feeling bad physically can change your worldview if it lasts long enough and is intense enough. For that reason, doctors may ask their patients to undergo psychological testing, along with the more measurable and observable back pain tests such as medical imaging, blood tests, and nerve tests.
In a psychological test, trained professionals (such as a psychiatrist or psychologist) who is trained to help people cope with pain problems, will interview you about such issues as your work situation, family life, possible substance abuse, diet and lifestyle, history of chronic pain, and any history of accidents or other possible events that caused your pain.
The therapist interviewing you about your pain levels and life and family situation won't make any assumptions until he/she learns more about your full life and medical history. The therapist will you questions about medical concerns that may be associated with pain, such as ability to concentrate, sleep or lack thereof, energy level, and state of mind (happiness, sadness).
After you have had one or more sessions with the therapist, he/she may consult with or report to your doctor with information to better understand your pain and, with understanding develop a treatment approach that include some stress management techniques. Some stress management techniques to manage chronic pain include techniques to make your work commute more comfortable, and relaxation techniques such as guided imagery.