When pain in the arm is 'all in the head': The management of medically unexplained suffering in primary care

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': The management of medically unexplained suffering in primary care. Health, Risk & Society, 8 (1). pp. 71-88. ISSN 1369-8575. (doi:https://doi.org/10.1080/13698570500532512) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

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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
Additional information: Unmapped bibliographic data: AD - Centre for Health Services Studies, University of Kent, Canterbury CT2 7NF, United Kingdom [Field not mapped to EPrints] AD - Medical Research Council, Bristol University, Bristol, United Kingdom [Field not mapped to EPrints]
Uncontrolled keywords: General practice, Patient-centred, Psychosocial, Somatization
Subjects: H Social Sciences
R Medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research
Depositing User: Mita Mondal
Date Deposited: 12 Mar 2014 14:09 UTC
Last Modified: 15 May 2014 12:45 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/38743 (The current URI for this page, for reference purposes)
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