Chronic pain is a tag that is used to describe pain that has lasted for a long time – more than 3 months being a common, but arbitrary, measure. A whole variety of specific medical conditions can cause pain which can be described as chronic.
The terms ‘pain syndrome’ and ‘pain disorder’ are often used when describing conditions causing chronic pain. These terms are often used interchangeably, even by doctors.
Strictly speaking, a ‘chronic pain disorder’ is a condition where psychological factors often play a role in the onset, severity, exacerbation or maintenance of the pain. That is not to say that the condition is in any way imagined. Far from it, the pain is very real. Whatever the condition causing the chronic pain, it must be remembered that pain is caused by a complex and interwoven mixture of physical and psychological factors. To put this into context, if you are referred for treatment to the multi-disciplinary pain clinic at your local hospital, you will usually be treated with a combination of physical and psychological therapy.
From the solicitors point of view, the type of chronic pain condition will determine which medical expert or experts should be instructed. For example, claimants suffering from Complex Regional Pain Syndrome (CRPS) or Myofascial Pain Syndrome (MPS)
should be diagnosed (in the medico-legal context) by consultants in pain medicine or rheumatology. On the other hand, a diagnosis for claimants suffering Somatoform Pain Disorder (SPD) should be sought from a consultant psychiatrist.
However, it is not as simple as saying that ‘syndrome’ equals a physical cause and ‘disorder’ equals a psychological cause. Far from it. Psychological factors will inevitably also be at work in cases involving a chronic pain syndrome. Certainly, where a claimant has a chronic pain syndrome, it would be most unusual not to additionally instruct a psychiatrist or psychologist. The reason for this is twofold. Firstly, chronic pain conditions, whether syndromes or disorders, usually have medically unexplainable features. Secondly, whatever the cause of the chronic pain, the often debilitating and life changing nature of the condition will have an understandably negative effect upon the sufferer’s mood, with many developing clinical depression and adjustment disorders.