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Pain in the absence of a physical cause
The patient's self-report is often a more accurate assessment of pain than are vital signs, outward behaviour or observer estimates2. The subjective experience of pain may occur in the absence of objectively demonstrable tissue damage. Pain is subjective and varies from person to person due to the complex interaction of cognitive, behavioural, emotional and physiological factors13.
Pain associated with unusual behaviour
Pain behaviours are a normal part of the experience of pain and are influenced by the individual’s upbringing, culture and individual circumstances14. The expression of pain behaviour is subject to the effects of learning. This may explain why some patients who have experienced pain for a lengthy period develop unusual behaviour or associate a particular activity with pain despite the lack of a real causal connection14. These patients require education and assistance to dissociate the negative learned behaviours and develop alternate techniques to alleviate pain. (See psychosocial assessment and non-pharmacological treatments).
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