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Chronic pain

This section covers a variety of types of chronic pain or ‘pain disorders’. 

A pain disorder can be extremely serious. The pain can often be so severe that it disables the injured party. It can last for a few days, or for many years. Pain disorders often occur after accidents involving serious injury. Symptoms can persist beyond the apparent physical recovery.

The Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association 4th Edition (DSM-IV) identifies three types of pain disorder:

  • Pain disorder associated with psychological factors

  • Pain disorder associated with both psychological factors and a general medical condition

  • Pain disorder associated with a general medical condition

The exact diagnosis depends on the ability of the medical expert(s) to explain the symptoms and any psychological influences.

Types of pain disorder include:

  • Fibromyalgia

  • Chronic pain syndrome and chronic regional pain syndrome

  • Chronic fatigue syndrome (also known as ME)

  • Conversion disorders (also known as dissociative disorders)

  • Somatoform disorders

Factors to be taken into account in connection with cases involving pain disorders include the following:

  • The degree of pain

  • The overall impact of the symptoms on a person’s mobility, ability to function from day to day and the extent to which they rely on others for help with aspects of their personal care

  • The effect on the injured person’s ability to work

  • The extent to which there is a reliance on medication to control the symptoms and the impact of that medication on day to day functioning

  • The extent to which treatment has been embraced and its effect (or the prospect of successful treatment in the future)

  • Whether the condition is limited to one anatomical site (as typically with chronic regional pain syndrome) or whether it is more widespread

  • The presence of any separately identifiable psychiatric disorder and its impact on the perception of pain

  • The age of the claimant

  • The long term prognosis

Cases involving pain disorders are typically complex and will demand a high level of medical and legal expertise.