Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Migrating Pain

Unfortunately, the risk to life and risk of law suit, forces everyone to practice defensively.

This means that even though you find nothing, you continue to look. A woman from another country wrote me recently that her all lab tests indicate that her depressed daughter is physically healthy, yet she runs a low grade fever every day.

While it is tempting to say that the fever is stress-related, you immediately become concerned that some significant physical problem is being overlooked.

Thus, when an injured worker has no objective reason for the pain, the search for a physical cause continues for many months beyond the point where the doctor is certain that there no physical cause will ever be found.

The patient is then sent to a pain center which also assumes that the pain is physical and numerous procedures and medications are used for another period extending months_and sometimes years.

Then, three years after the injury, someone takes a gamble and says _this is probably psychological._

I see the patient at that time, and it is stunning how many horrible (not related to injury) events have happened and are happening in the patient_s life.

By this time, the patient may have become completely resistant to accepting that his/her problems are not related to injury.

Early cop-outs on the psychological diagnosis always lead to later problems.

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