Functional vs. organic pain: a meaningful distinction?

Abstract

This study examined the statistical and clinical validity of the distinction frequently made between "functional" pain and "real" pain. Earlier work has relied on the MMPI exclusively and results have been inconclusive, yet the distinction continues to be made and treatment is recommended on the basis of the label. Sixty-seven chronic back pain patients were administered questionnaires that assessed quantity and quality of depression, dimensions of illness behavior, and psychogenic attitudes. Scores of chronic pain patients were compared to normal subjects, and results indicate that the pain subjects experienced high levels of depression, anxiety, and social alienation. However, organic pain subjects did not differ from subjects with no organic findings. The authors suggest that the distinction between organic and functional pain be discarded in favor of an approach that assesses current emotional stressors and available coping mechanisms.