Psychic Syndromes Expressed as Musculoskeletal Symptoms.—
Some patients who, over a period of time, experience musculoskeletal symptoms without objective pathologic findings have very mild disease or disease that is not yet fully manifest. The remainder are persons whose symptoms cannot be related to structural or other changes in joints but rather arise in conjunction with psychological disturbance. These patients often have many bodily symptoms. They complain of pain in joints and muscles. They experience soreness or tenderness of the involved parts. Stiffness is a frequent complaint and increased muscle tension may be found. Examination, however, shows no swelling or other objective signs of joint inflammation. Further study usually reveals that their psychological distress has manifested itself in the past in numerous somatic symptoms and is more widespread than that arising from the presenting symptom alone.The development of such symptoms has been accounted for by two mechanisms. The more important
Section 68.—Psychological Aspects of Rheumatic Diseases. JAMA. 1973;224(Suppl_5):788–790. doi:10.1001/jama.1973.03220190128071
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