Emotional factors in persistent pain states.

Physicians are often disturbed and made angry by the seeming perverseness of patients who fail to get well under the best of treatment. Intractable pains of headaches, tic-douloureux, disc syndrome, bursitis, rheumatoid arthritis, reflex sympathetic dystrophy, phantom limb, and Raynaud's phenomenon are among the most frequent sources of therapeutic frustration. Neurosurgical attempts to relieve pain with problem patients are sometimes comparable to dynamiting the powerhouse to turn off the kitchen light. The distress of sensory deprivation with nerve section may be worse than the original pain.