Pain Disorders in Personal Injury Claims

by Kidd Rapinet on June 16, 2023
Vashti Prescott

A personal injury lawyer will often see in cases reference to “somatoform disorders”, “complex regional pain syndrome” and “fibromyalgia” – but what do they mean ?
Somatoform disorders, complex regional pain syndrome (CRPS), and fibromyalgia are all medical conditions that involve chronic pain and have distinct characteristics and diagnostic criteria. Here’s an overview of each condition and their differences:

  1. Somatoform Disorders: Somatoform disorders are a group of mental health conditions in which individuals experience physical symptoms that cannot be fully explained by an underlying medical condition. These symptoms are not intentionally produced or feigned. Instead, they cause significant distress and impairment in functioning. Examples of somatoform disorders include somatic symptom disorder, illness anxiety disorder, and conversion disorder. The focus of these disorders is on the psychological factors underlying physical symptoms.
  2. Complex Regional Pain Syndrome (CRPS): CRPS, previously known as reflex sympathetic dystrophy (RSD), is a chronic pain condition that typically affects one limb, often after an injury or trauma. It is believed to involve dysfunction of the peripheral and central nervous systems. Symptoms of CRPS include intense pain, swelling, changes in skin colour or temperature, and limited range of motion. CRPS is characterised by disproportionate pain compared to the initial injury, and it can cause significant physical and functional impairments.
  3. Fibromyalgia: Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness at specific points on the body called tender points or trigger points. Individuals with fibromyalgia may also experience sleep disturbances, cognitive difficulties (often referred to as “fibro fog”), and mood disturbances. The exact cause of fibromyalgia is unknown, but it is believed to involve abnormalities in the way the central nervous system processes pain signals. It is often diagnosed based on a combination of symptoms and physical examination findings.

While all three conditions involve chronic pain, they have distinct differences:

  • Somatoform disorders are primarily mental health conditions characterized by physical symptoms that cannot be fully explained by an underlying medical condition. The focus is on the psychological factors contributing to these symptoms.
  • CRPS is a specific chronic pain condition that typically affects one limb, often after an injury. It is characterised by intense pain, swelling, and changes in skin colour or temperature.
  • Fibromyalgia is a chronic pain disorder characterised by widespread musculoskeletal pain, fatigue, and tender points on the body. It often involves sleep disturbances and cognitive difficulties.

It’s important to note that diagnosing these conditions can be complex. Among the healthcare professionals a multi-disciplined approach is required in order to make an accurate diagnosis. Rheumatologists, pain specialists and neurologists willoften need to consult.

When these disorders present themselves in a personal injury claim it can be very distressing for both the Claimant and the lawyer. The Claimant is clearly in pain and has no idea why they are experiencing the pain. There is rarely an early diagnosis as the investigation procedure is usually very long and drawn out. The Claimant usually feels that they are being pushed from pillar to post without anyone really telling them what is happening to them.

From the lawyers point of view there is still a “stigma” attached to these disorders – particularly somatoform disorders. There is usually an inference from the Defendant (or sometimes an outright allegation) that the Claimant is “making up” their symptoms in order to string the litigation process along and gain a higher level of compensation that they would otherwise be entitled to.

With fibromyalgia, some medical professionals do not even believe that the condition exists. It is easy if you have a broken bone to account for ongoing pain, but much more difficult where there has been a mild soft tissue injury which has developed into chronic widespread pain – not just at the original point of injury – but throughout the whole body. Doctors do not recognise pain they cannot see or diagnose. Again, the inference is usually that the Claimant is deliberately malingering or it is “all in the mind” (and therefore not “real”). Many doctors would rather diagnose the condition as somatoform disorder than say it is “fibromyalgia”.

The same can be said with CRPD. The fact that the pain continues long after the injury has healed (ie the broken arm or wrist) raises questions as to whether the Claimant is malingering in order to maximise their compensation.

The secret to succeeding in bringing claims for these disorders lies in ensuring that you have a good personal injury lawyer, who will instruct the right experts who will follow a step by step approach to identifying the disorder – usually by a process of elimination – and then putting together a multi-disciplined treatment programme.

This article has been brought to you by Vashti Prescott, a personal injury lawyer at Kidd Rapinet Solicitors Canary Wharf, who is registered as a Senior Litigator with the Association of Personal Injury Lawyers (APIL), Pan European Organisation for Personal Injury Lawyers (PEOPIL) and an Accredited member of the Law Society Personal Injury Lawyers.  You can reach Vashti using the form provided or call 0207 265 5486.

These materials and content have been prepared for the benefit of their viewers/readers. They are intended for marketing purposes only and are of a general nature and do not constitute legal advice applicable to any particular facts or circumstances. Kidd Rapinet LLP and/or the author(s) accept no duty of care, responsibility or liability for any loss or damage which you or any third party may suffer as a result of any reliance or use by you or them of these marketing materials and content, except to the extent it is not legally possible to exclude such liability. If you require legal advice on your own situation, please contact us so we can discuss how we may assist.

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