Activity 11.1: Reflective practice

Take some time to reflect upon your own clinical practice.

Can you identify examples of individuals with organic or psychogenic pain?

Can you identify the pathophysiology of the pain process in those individuals?

You may find that when you look back at the different patients you have nursed and the classification of pain you will be able to identify the type of pain they were experiencing. Organic pain is pain caused by an organic lesion. Psychogenic pain is physical pain caused by, increased or prolonged by mental, emotional or behavioural factors – these can include headache, back pain, or stomach pain. It is usually used to describe a pain disorder attributed to psychological factors, i.e. beliefs, fears, and strong emotions can cause, increase, or prolong pain.


Headaches are thought to be caused by activation of peripheral nerves in the head and neck muscles


Is caused by a physical abnormality, i.e. constipation causing pressure on the nerves resulting in pain


  • A slipped/prolapsed disc (a disc of cartilage in the spine pressing on a nerve) – causes back pain and numbness, tingling and weakness in other parts of the body
  • Irritation of the nerve that runs from the lower back to the feet (sciatica) – this can cause pain, numbness, tingling and weakness in the lower back, buttocks, legs and feet
  • swelling of the joints in the spine (ankylosing spondylitis) – this causes pain and stiffness that’s usually worse in the morning and improves with movement
  • a bone in the spine slipping out of position (spondylolisthesis) – this can cause lower back pain and stiffness, as well as numbness and a tingling sensation

Very rarely, back pain can be a sign of a serious problem such as:

  • a broken bone in the spine
  • an infection
  • cauda equina syndrome (where the nerves in the lower back become severely compressed)
  • cancer