Robert Tobias

By Marek Rózycki and Robert Tobias

Pain is the subjective sensation closely related to disease and treatment. Very often its diagnosis is more an expression of the diagnostician’s experience than a description of the patient’s actual condition. In particular, orthopedic and neurological patients who develop Complex Regional Pain Syndrome are misdiagnosed because the intensity of their sensations is disbelieved. Based on case studies, it seems appropriate to introduce an additional category of patient experience that will enable prompt recognition and appropriate treatment. The misdiagnoses under evaluation also exhibit frequent improper practitioner responses to patients’ experience, ranging from open expressions of disbelief, through indifference, to helplessness and pessimism. This article presents case studies in which patients’ expressions of suffering were not used to modify the treatment. Rather, medical professionals accepted the pain as normal under the circumstances and resulting from tissue damage. However, in these cases, the pain was a symptom of a new disease entity, in development since the original diagnosis. With improved patient communication and treatment procedures, such oversights can be avoided and new disease entities will be more readily diagnosable.

Part of the book: Pain Management