Psychosomatic therapy for chronic pain disorder (Lumbago) closely related to conversion disorder as a psychological mechanism

The case of a 26-year-old woman who had been suffering from lumbago since the age of 14 earlier is herein reported. She also demonstrated claudication because of lumbago. Numerous examinations revealed no abnormal findings except for a slight lumbar disc herniation, and conventional orthopedic therapy such as traction only worsened her symptoms, thus she was eventually admitted to our department of psychosomatic medicine. The psychological interview revealed that she had felt stress from her over interfering mother since her childhood and that she could only avoid the unpleasant feelings by means of her symptoms. It was thus suggested that some psychological mechanism existed as a conversion disorder for her symptoms. She also indicated that her mother, coworkers and the previous medical staff did not show sufficient understanding for her symptoms, and such feelings were also considered to be contributive factors for the continuation of her symptoms. We therefore showed acceptance and sympathy for her pain while taking a neutral attitude to her pain behavior. We also performed family therapy in order to help reduce the stress in the family environment. As a result of this psychological treatment, her pain behavior began to gradually decrease.