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There is an excellent article in the Los Angeles Times entitled When pain becomes chronic. Here is an excerpt:

Pain is usually a symptom of something else — a scraped knee, a broken arm, appendicitis. Treating the pain makes the patient less miserable, but it’s just a stopgap measure until the underlying problem is fixed and the pain goes away — the scrape heals, the bone knits back together, the appendix is removed.

With chronic pain, however, the underlying problem that started it has usually (though not always) been fixed and yet the patient is still hurting. A malfunctioning nervous system has started manufacturing pain. The pain is no longer simply a symptom. It has become a problem in its own right.

No one knows a sure-fire way to avoid chronic pain. Still, you can improve your chances by avoiding the temptation to simply tough it out when you get injured. “Luckily, if treated adequately, pain goes away in a majority of patients,” says Dr. Talal Khan, a specialist in anesthesiology, pain management and pain medicine at the University of Kansas Hospital in Kansas City. “But once chronic pain develops, it can be very hard to cure.”

And then it can be devastating. “Patients are often disabled,” Webster says. “They live with a tremendous amount of pain even with top-of-the-line treatment.”

The entire article is worth reading, but the key takeaway for me is that chronic pain is not always a symptom of something else. It is a problem in its own right.

I have may clients that are disabled due to chronic pain. Perhaps because the cause of the pain is not always clear, claimants are rarely credited with the severity of the pain they feel (see, for example, DDS and Claims Involving Chronic Pain). 

Because pain is subjective, often the focus of the disability claim becomes the credibility of the claimant rather than the medical record. The SSA has a regulation, 20 C.F.R. 404.1529, entitled “How we evaluate symptoms, including pain.” The regulation discusses the factors that must be considered by the judge when assessing credibility. Social Security Ruling 96-7p also discusses those factors.

When evaluating a Social Security disability claim involving chronic pain, it is important to recognize that chronic pain is a problem in its own right, not just a symptom of something else.