Pierre’s back pain was triggered by a car accident that happened while he was driving on the job. He was struck from behind as he was sitting at a traffic light. The force of the collision was not enough to push his car forward and caused almost no damage to the vehicle. The pain in his lower back, however, is severe and constant, and the only way he can get any relief is by taking high doses of pain medication, including opioid drugs.
“Ever since that drunk driver rear-ended my car 18 months ago, I haven’t been able to work doing my deliveries or even go out with my friends. The pain is so bad at night that I haven’t slept for more than three hours a night in the past five months. Things improved for a couple of weeks, but then got worse again. The bills are piling up, and my lawyer says the insurance company isn’t paying me what I deserve. Part of the problem is that I just can’t seem to get a clear diagnosis from my doctor.”
While Pierre’s back pain may have started with the car crash, the amount of injury would have been minor and long since completely healed. His level of pain as the result of such a minor injury, his slow recovery and other aspects of the situation—his anxiety, anger, sleeplessness, reliance on medication—suggest that he may now be suffering from a more complex pain disorder with significant psychological features.
People who develop this pain disorder are constantly seeking the ‘right’ diagnosis, tend to blame others for their situation, and may be unable to work and socialize normally. Pain has become the focus of their existence, and overuse of pain medication is common.
Once a pain disorder has been properly diagnosed and explained, people like Pierre may benefit from behavioral and cognitive therapy. They may also be treated with anti-depressants and other medications aimed at modifying their responses to pain.