Many people believe that pain is either real or imaginary. They might say that real pain should be treated medically while imaginary pain should be left to the psychiatrists.

But how can we tell real from imaginary pain? Pain is a sensation, not something that can be seen on a MRI or detected with a blood test. Nevertheless, when medical testing fails to find a plausible cause for someone’s pain, many doctors will invoke psychological causes.

This kind of reasoning assumes that our current medical technology is capable of detecting any and all possible organic causes of pain, a dubious assumption at best.  It has only been in the past few years that our technology has allowed us to demonstrate conclusively that conditions such as migraine and fibromyalgia have an organic basis. Chest pain following mastectomy was considered a psychiatric illness for years until it was shown that things like nerve injury during surgery could lead to chronic pain.

As our understanding of how the nervous system works increases, our ability to explain (and treat, we hope) many painful conditions should also increase. It is quite likely therefore that pain that is now considered imaginary or psychological only because we have no other explanation will be found to have an organic basis.