When pain in the arm is all in the head: risk and the management of medically unexplained suffering

Wainwright, David and Calnan, Michael .W. and O'Neill, Claire and Winterbottom, Anna and Watkins, Christopher S. (2006) When pain in the arm is all in the head: risk and the management of medically unexplained suffering. Health, Risk & Society, 8 (1). pp. 71-88. ISSN 1369-8575. (The full text of this publication is not available from this repository)

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Official URL
http://dx.doi.org/10.1080/13698570500532512

Abstract

Cases of medically unexplained arm pain pose a dilemma for general practitioners. The absence of observable physical pathology implies a psychosocial problem, but patients often insist that their illness is bio-mechanical. Should the doctor risk invalidating the patient's claims and damaging the doctor – patient relationship, by insisting on a psycho-social explanation, or follow the patient's wishes and prescribe treatments which are likely to be ineffective? Findings from a qualitative study of 14 general practitioners in the South West of England are presented and discussed in the context of the sociology of suffering. The findings indicate a high degree of clinical uncertainty in dealing with non-specific arm pain cases and identify a range of strategies adopted to manage this uncertainty and the problems associated with it. Critics of ‘bio-medicine’ have argued that it focuses narrowly on physical pathology, while neglecting the patient's subjective beliefs and emotional needs. Our findings question this view, suggesting that GPs are often prepared to set aside the rigour of clinical science and the search for physical pathology in order to avoid invalidating the patient's claim that their illness is bio-mechanical rather than psycho-social. While this conforms to cultural expectations of what constitutes an appropriate response to human suffering, it may not be in the patient's best interests.

Item Type: Article
Uncontrolled keywords: Psychosocial, somatization, patient\-centred, general practice
Subjects: H Social Sciences
H Social Sciences > HV Social pathology. Social and public welfare
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Faculties > Social Sciences > School of Social Policy Sociology and Social Research
Depositing User: Samantha Osborne
Date Deposited: 19 Dec 2007 18:26
Last Modified: 18 Jul 2014 15:43
Resource URI: http://kar.kent.ac.uk/id/eprint/727 (The current URI for this page, for reference purposes)
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