2004 Volume 11 Issue 4 Pages 424-428
We report 3 cases of intractable lower limb pain, in which pain relief was hardly obtained by conventional pain treatments and the involvement of psychogenic factors was strongly suspected.
The common clinical features consisted of swelling, coldness, severe continuous pain, and movement disability in the lower limb. In case 1, the limb pain developed after Chiari osteotomy. However, we could not detect organic disorders that would explain the complaints in any of these cases. While we mainly performed nerve block therapy including drug therapy for these patients, the patients never indicated any pain reduction. Because psychogenetic factors were considered to be involved in each complaint based on interviews with the patients, we performed Minnesota Multiphasic Personality Inventory (MMPI) test as a psychological examination. The results were highly indicative of a psychogenic disorder contributing to the pain complaint in each case.
Since the clinical features of chronic pain arose in each patient after a modified psychogenic process, we concluded that a psychological approach in addition to conventional pain treatment is indispensable for the treatment of chronic pain.
