- Often secondary to dealing with some psychic conflict
- Pain is usually continuous rather than recurrent
- Paralysis, anesthesia, or hyperesthesia may also occur.
- Pain appears to alleviate stress by focusing attention on the patient and
thereby interrupting the family conflict.
- Examples include:
- Psychogenic pain disorder
- Conversion disorder
- Somatization disorder
- Exam is normal unless affected limb may have been immobile for a long
- If vasomotor instability and edema are found, especially with
hyperesthesia, consider Reflex Sympathetic Dystrophy.
- RSD occurs in later childhood and adolescence.
- Patient characteristically holds the limb in a bizarre posture as if
unable to move it.
- Origin often has an emotional component.
- Treatment is rigorous physical and occupational therapy program and
activity; as well as a search for the underlying emotional problems. Possible
referral to a psychiatrist or psychologist.
CHLA Board Review 2005