Chronic Pain That Doesn't Heal: Be Alert to "Somatic Symptom Disorder"

In a recent clinic encounter, a 30-year-old male patient presented with neck pain, dizziness, and scalp numbness, seeking treatment for cervical spondylosis. Despite undergoing various treatments, his symptoms persisted for a long time. He brought a range of medical test results, including X-rays, MRIs, ultrasounds, and transcranial Doppler exams. These tests indicated mild cervical degeneration, but no other abnormalities were found.

When asked about his treatment history, the patient inquired about how to treat cervical spondylosis. Upon physical examination, there were no significant signs of cervical spine issues. After further probing into his medical history, it became evident that the patient also had insomnia and emotional instability. This led me to suspect that his symptoms were not caused by cervical spondylosis but could be manifestations of somatic symptom disorder (SSD), presenting as chronic pain. After a consultation with a neuropsychologist, the diagnosis was confirmed, and after receiving specialized treatment, the patient’s long-standing condition began to improve.

What is Somatic Symptom Disorder?

Somatic symptom disorder is a common condition in clinical neuropsychology. It primarily arises due to psychological conditions like anxiety or depression, which manifest as physical symptoms. It is more prevalent in women and is characterized by persistent, widespread pain and discomfort in various body parts. Despite extensive medical tests, no organic cause can be found for the pain. Typical pain sites include the head, face, neck, back, or chronic pelvic pain. The onset is often linked to emotional conflicts or psychological-social issues and tends to increase when the patient receives more attention and support from medical professionals or personal relationships.

Characteristics of Patients with Somatic Symptom Disorder: Patients with SSD often focus all their attention on their pain and attribute all their problems to it. They may also experience emotional disturbances, such as anxiety or depression, and insomnia. However, due to the chronic nature of their pain, these emotional symptoms may be overshadowed, leading them to deny any underlying psychological or interpersonal issues.

Keywords: Somatic Symptom Disorder, Cervical Spondylosis, Pain, Anxiety, Depression