Pain is one of the most personal and complex human experiences. For some, pain begins with a clear injury or diagnosis. For others, it emerges mysteriously—without a detectable physical cause, yet just as real and debilitating. This phenomenon, known as psychogenic pain, challenges both patients and practitioners alike. According to Jordan Sudberg, a leading pain management specialist, understanding psychogenic pain is crucial in helping those whose suffering doesn’t show up on scans but still affects every part of their lives.
“Psychogenic pain isn’t imaginary,” says Dr. Sudberg. “It’s misunderstood. It stems from the brain and emotions, not necessarily from tissue damage, but that doesn’t make it any less real or less worthy of treatment.”
In this article, we’ll explore what psychogenic pain is, how it manifests, and why holistic, compassionate care is essential—insights shaped by Dr. Sudberg’s extensive work in integrative pain management.
What Is Psychogenic Pain?
Psychogenic pain refers to physical pain that is primarily caused or exacerbated by psychological factors such as stress, anxiety, depression, or trauma. While the pain may not have an identifiable physical origin, it is not “fake” or “in the patient’s head” in a dismissive sense.
Dr. Sudberg explains, “Pain is processed in the brain. If the brain’s pathways are disrupted by emotional distress, the nervous system can misfire—creating sensations of pain without an actual physical trigger.”
Common forms of psychogenic pain include:
- Chronic headaches or migraines
- Muscle pain, especially in the neck and back
- Abdominal pain
- Chest pain (not cardiac-related)
- Widespread joint discomfort
These types of pain are often persistent and can worsen under emotional strain, making diagnosis and treatment challenging.
Understanding the Brain-Body Connection
Our brains are central to how we experience pain. Emotional distress can trigger the same neural circuits that process physical pain. For individuals with psychogenic pain, these circuits remain “on,” even in the absence of a physical injury.
“Think of the nervous system like a car alarm that keeps going off, even when there’s no break-in,” says Jordan Sudberg. “It’s reacting to a perceived threat—often psychological—rather than a real one. But to the patient, the pain feels identical to that caused by a physical injury.”
The stigma surrounding mental health often leads patients to feel dismissed or invalidated when their pain can’t be traced to a medical scan. That’s why education and empathy are central to effective care.
Diagnosing Psychogenic Pain
Diagnosis often begins by ruling out physical causes. Once serious underlying conditions have been excluded, clinicians like Dr. Sudberg take a broader, biopsychosocial approach—looking at the whole person, not just the pain symptoms.
“A good pain specialist looks for patterns,” explains Dr. Sudberg. “If pain worsens with emotional stress or doesn’t respond to conventional treatments, that’s a signal that the mind and body are deeply intertwined in the patient’s experience.”
Dr. Sudberg also emphasizes the importance of collaborative care. Psychologists, psychiatrists, and physical therapists often play key roles in developing an effective treatment plan.
Treatment: Addressing Pain from the Inside Out
Psychogenic pain requires a holistic treatment plan that addresses both the emotional and physical aspects of pain. Dr. Sudberg outlines several evidence-based strategies:
- Cognitive Behavioral Therapy (CBT): Helps patients identify negative thought patterns and emotional triggers contributing to pain.
- Mindfulness-Based Stress Reduction (MBSR): Teaches awareness and relaxation techniques that calm the nervous system.
- Physical Therapy: Gently reintroduces movement and function while reinforcing that the body is safe.
- Medication: In some cases, antidepressants or anti-anxiety medications can modulate pain signaling pathways.
- Lifestyle Adjustments: Sleep, nutrition, and social support all influence pain perception and emotional resilience.
“Pain is never just physical or just emotional,” Dr. Sudberg says. “It’s always both. That’s why we have to treat the person, not just the symptom.”
The Importance of Compassionate Care
For patients suffering from psychogenic pain, validation is often the first step toward healing. Being told “it’s all in your head” can increase isolation and despair.
Jordan Sudberg emphasizes that providers must listen without judgment and affirm the reality of the patient’s pain. “Just because we can’t see the cause doesn’t mean the pain isn’t real,” he says. “Our job is to believe our patients—and help them believe in their recovery.”
Conclusion: Hope Beyond the Hurt
Psychogenic pain may be invisible on an X-ray, but its impact is deeply felt. With compassion, a multidisciplinary approach, and a strong understanding of the mind-body connection, recovery is possible.
Jordan Sudberg continues to advocate for a future where psychogenic pain is better understood and more openly discussed. “This isn’t about proving pain exists,” he says. “It’s about restoring dignity, function, and hope to people who’ve been told for too long that their pain doesn’t matter. It does—and so do they.”