Mindset

Somatization Disorder

By on November 14th, 2016

Psychologists and psychiatrists use the term “somatization disorder” to characterize significant complaints about bodily pain and other physical problems that cannot be fully explained by a medical condition upon examination. This disorder is commonly seen in patients with irritable bowel syndrome, headaches, and reproductive issues like impotence or infertility.

One theory behind somatization disorder is that the body has a limited capacity to cope with psychological, emotional, and social trauma. Beyond that point, the “overflow” is experienced as a physical disorder. Another theory is that such individuals have developed a heightened sensitivity to pain over time. And yet a third theory is that patients “catastrophize”, or use distorted negative thinking to believe that minor ailments, like mild muscle pain or shortness of breath, are actually evidence of a serious illness such as cancer, heart disease or a tumor.

Even though I don’t consider myself prone to catastrophizing, I have definitely experienced this phenomenon myself more than once. There was one time where I developed symptoms that were very much like those of a cervical disc herniation. During a period of repeated and particularly taxing scoliosis surgeries, I experienced pain that radiated from my neck down my arm into my thumb.

I was sure I had a herniated disc and would need neck surgery. So I ordered an MRI of my spine. But there was no evidence of a herniated disc or severe nerve impingement. Eventually, I recognized that my pain was likely due, at least in part, to unconsciously shrugging my shoulders very slightly during long periods of intense concentration when the stakes were high.

Spine surgery requires a surgeon to spend hours in awkward positions to work in small areas that are tucked away in the body. I frequently tilt my neck for hours on end to decompress a nerve appropriately or insert instrumentation in less than ideal ergonomic conditions. After consideration, I noticed that when I got into those types of situations, I would actually shrug up my shoulders a bit.

Even though I saw myself as very relaxed in the operating room, I was unaware that I was tensing muscles ever so slightly, but for long periods of time. My understanding of spinal conditions, their symptoms, and distaste at the thought of requiring surgery myself made the pain grow in impact in my consciousness. Once I became aware of my overdramatic thought patterns and my poor posture—and began some specific neck exercises to strengthen the neck muscles throughout my range of motion—my pain completely went away.

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Kamshad Raiszadeh, M.D.

Dr. Raiszadeh's completed medical school at UC San Francisco, orthopedic surgery residency at UC Davis and his Pediatric and Adult Spine Fellowship at the Hospital for Joint Diseases/NYU in New York City. He has 20 years of experience with the broad range of spine surgery including minimally invasive surgery, complex spinal disorders such as scoliosis and kyphosis, and cervical spine disorders. During this 20 years he has noticed a dramatic increase in patients turning to surgery for treatment of neck and low back pain, but many of them not getting their desired long-term result. He therefore became increasingly interested in improvement and standardization of non-operative treatment. By developing the best aspects of non-operative treatment in an atmosphere of empowerment to maximize the body’s own healing capacity, he noticed that many fewer patients required surgery, and the ones who underwent surgery had much better long term results.