Fernades C, Cordova MJ, Katz L, Wong SJ
Among the patients referred to a specialty pain clinic, there exists a subset that is particularly challenging. Often these patients have been evaluated by multiple medical specialists without an identifiable organic cause for their symptoms and have proven refractory to an array of treatment modalities. They are severely debilitated by their pain and extreme in their presentations. These patients are referred to as cases of “complex chronic pain”; in the words of Carron, they display “minimal pathology with maximum dysfunction.”(1) Frustrated with the lack of a diagnosis and resolution of their symptoms, these patients present to the pain clinic.