Articles: pain.
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The concept of psychogenic pain is discussed and reviewed from multiple theoretical perspectives. The validity of psychogenic pain disorder as a clinical diagnosis is also examined, as are regional pain syndromes such as psychogenic abdominal, facial, pelvic, chest, and headache pain. The term "psychogenic pain" is considered to have limited clinical or diagnostic usefulness and the preferred term "idiopathic pain syndrome" used in DSM-III-R is advocated.
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At Howard University Hospital, nine terminally ill cancer patients with chronic pain have been treated with continuous intrathecal infusion of morphine delivered by the implantable Infusaid pump. The case of a patient treated at Howard University Hospital with this method of pain management is presented. Following Infusaid pump insertion, the patient lived for 22 months and obtained substantial relief of his cancer pain with no adverse side effects.
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The method for cancer pain relief proposed by the World Health Organization (WHO) consists of guidelines for a three-step treatment, from non-opioids to weak and then strong opioids, according to need. Adjuvant drugs can be added to each step. This report presents the 2-year experience of the WHO Collaborating Centre at the National Cancer Institute of Milan in the use of this method. ⋯ Neurolytic procedures had to be used in 29%. The authors conclude that analgesics, as proposed by WHO, are the most suitable treatment arm in controlling pain in palliative treatment for advanced cancer patients. Lack of availability or underuse of opioids constitute the real obstacle to the application of this method.