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Misdiagnosis of Chronic pain

Misdiagnosis of Chronic pain

A diagnosis of the chronic pain begins with taking a thorough health history, including symptoms, and performing a physical exam.

A diagnosis of chronic pain may be overlooked or delayed because symptoms may be mild in some people and may be easily attributed to other causes, such as aging. Some people with chronic pain may also delay treatment because they believe that chronic pain is not treatable and accept it as an unavoidable part of some conditions, such as arthritis. Additionally, every person with chronic pain can experience different types and severities of symptoms, and not all people will have extreme pain.

Although chronic pain is a very real experience, it is common for people to incorrectly believe that chronic pain is "all in the head" and not a real or valid condition. Because of this people who have symptoms of chronic pain should seek a diagnosis from a licensed health care clinician, ideally a pain specialist....more about Chronic pain »

Alternative diagnoses list for Chronic pain:

For a diagnosis of Chronic pain, the following list of conditions have been mentioned in sources as possible alternative diagnoses to consider during the diagnostic process for Chronic pain:

Chronic pain: Hidden Causes Misdiagnosed?

Causes of Chronic pain may include these medical conditions:

Rare Types of Chronic pain:

Chronic pain: Undiagnosed Conditions

Commonly undiagnosed conditions in related areas may include:

Common Misdiagnoses and Chronic pain

Cluster of diseases with difficult diagnosis issues: There is a well-known list of medical conditions that are all somewhat difficult to diagnose, and all can present in a variety of different severities. Diseases in this group include multiple sclerosis, lupus, Lyme disease, fibromyalgia, thyroid disorders (hypothyroidism or hyperthyroidism), chronic fatigue syndrome, diabetes - all of these can have vague symptoms in their early presentations. Also, depression can have some symptoms similar to these conditions, and also the reverse, that many of these conditions can mimic depression and be misdiagnosed as depression.

Leg cramps at night a classic sign: The symptom of having leg muscle cramps, particularly at night, is a classic sign of undiagnosed diabetes. However, there are also various other causes. See causes of leg cramps or misdiagnosis of diabetes.

Vitamin B12 deficiency under-diagnosed: The condition of Vitamin B12 deficiency is a possible misdiagnosis of various conditions, such as multiple sclerosis (see symptoms of multiple sclerosis). See symptoms of Vitamin B12 deficiency or misdiagnosis of multiple sclerosis.

Failure To Diagnose Chronic pain

Failure to diagnose Chronic pain may be associated with the following:

  • Chronic pain is a symptom common to many conditions and thus it is often difficult to diagnose accurately
  • Undiagnosed and untreated chronic pain can result in complications such as depression, anger, reduced self-esteem and an impaired ability to function in their day to day activities
  • A diagnosis of chronic pain relies solely on the patients report as there is no test for pain. Often chronic pain caused by an undetected injury may be dismissed by health professionals as being imagined pain
  • Chronic pain is often undiagnosed in patients who have healed from an injury as the patients either feel that the pain will eventually resolve or that the doctor wouldn't believe them if they complained about persisting pain. Patients simply try to manage the pain on their own and occasionally even self-medicate by using such things as alcohol, marijuana or other medications
  • Undiagnosed chronic pain can have a serious underlying cause which can become progressively worse if the diagnosis and treatment is delayed
  • Generalized pain syndrome such as fibromyalgia is particularly difficult to diagnose and treat with the underlying cause frequently being misdiagnosed
  • Often there is not easily determined cause of generalized or specific pains (especially visceral pain) and it may be ignored by patients and doctors. Doctors and patients may adopt a "wait and see" approach chronic pain
  • Chronic pain is often undiagnosed as there is insufficient knowledge and understanding about chronic pain by health professionals and patients. There is also a lack of publicity about the condition which fuels the problem of undiagnosed chronic pain. Patients often feel that a chronic pain is just something they need to deal with and not a problem to seek medical advice about
  • Chronic pain may also be undiagnosed in some cases where the patient is perceived to be complaining about a fictitious pain or exaggerating their pain symptom in order to obtain prescribed medication due to a drug-dependence problem
  • Chronic pain in infants is very hard to diagnose as there is often little in the way of clues that help determine the cause of the pain even though the infant presents with obvious signs of pain
  • Many patients fail to seek treatment for chronic pain as they believe that nothing can be done or they don't want to bother their doctor with a condition they feel is untreatable - thus chronic pain is widely undiagnosed and under-treated.

Notes On Hidden Causes Of Chronic pain

The following may be hidden causes of Chronic pain:

  • The list of causes of chronic pain is extensive and includes: bone spurs, depression, arthritis, coccydynia, degenerative disc disease, fibromyalgia, facet joint disorders, herniated disc, scoliosis, lupus, scleroderma, endometriosis, infection, neuropathy, muscle strain, piriformis syndrome, osteoporosis, sacroiliac joint dysfunction, sciatica, spinal stenosis, spondylolisthesis and spondylolysis
  • A hidden cause of chronic pain may be complication of a surgical mistake (e.g. equipment or materials being left in the body following surgery)
  • Congenital malformations (e.g. Chiari malformation, intestinal defect) are often overlooked as a cause of chronic pain
  • Metastatic cancer is often overlooked as a possible cause of chronic pain
  • Post-traumatic stress disorder may be a hidden cause of chronic pain such as headaches
  • Electric-shock and lightning strikes are rarely considered as a possible differential diagnosis in determining the cause of chronic pain - especially if the patient fails to mention the event.
  • Injuries that don't heal properly (e.g. an improperly set bone fracture) may be overlooked as a cause of chronic pain if the normal healing period has passed and the injury appears physically fine
  • In some cases, the cause the cause of chronic pain is unknown despite extensive testing and investigations

Notes On Wrong Diagnosis Of Chronic pain

Wrong diagnosis of Chronic pain may be associated with the following:

  • Chronic pain may be misdiagnosed as hysteria or malingering or the patient may be dismissed as a hypochondriac
  • Chronic pain may be difficult to diagnose and health professionals often misdiagnose the pain as being psychogenic when various tests reveal no cause for the pain
  • The chronic pain caused by vulvodynia is often misdiagnosed with chronic yeast disorders or psychological problems
  • Mental disorders such as depression and anxiety may be a hidden cause of chronic pain and are difficult to diagnose as patients often only report physical symptoms rather than non-physical symptoms. Conversely, patients suffering from chronic pain due to some other underlying illness may be misdiagnosed with depression
  • Chronic pain types and possible causes which can be a source of misdiagnosis:
  • Chronic bone pain - osteoporosis, bone cancer, osteomyelitis or arthritis.
  • Chronic visceral pain - chronic pancreatitis, gallstones, appendicitis, indigestion, constipation.
  • Muscle cramps
  • General somatic pain - depression, fibromyalgia, chronic back pain, physical trauma.
  • Peripheral neuropathy - diabetes, shingles, AIDS, nerve pain, sciatica, ruptured spine disc.
  • Chronic pain due to circulatory problems - rheumatoid arthritis, poor circulation, blood vessel blockage, reflex sympathetic dystrophy.
  • Headache - migraine, sinusitis, trigeminal neuralgia, giant cell arteritis, brain tumors.

Medical news summaries about misdiagnosis of Chronic pain:

The following medical news items are relevant to misdiagnosis of Chronic pain:

General Misdiagnosis Articles

Read these general articles with an overview of misdiagnosis issues.

About misdiagnosis:

When checking for a misdiagnosis of Chronic pain or confirming a diagnosis of Chronic pain, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis. These alternate diagnoses of Chronic pain may already have been considered by your doctor or may need to be considered as possible alternative diagnoses or candidates for misdiagnosis of Chronic pain. For a general overview of misdiagnosis issues for all diseases, see Overview of Misdiagnosis.

 

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