Category: Clinical Insights

Is the Claimant’s Pain Report Genuine?

Most chronic pain reports are genuine, and the assessment should start there. Dr Richard Sawyer explains how a pain expert distinguishes exaggeration from malingering, which features warrant closer scrutiny, what base-rate research shows, and why any finding of dishonesty remains a matter for the court.

Chronic pain causation when pain becomes the main injury

When chronic pain outlasts tissue healing, the orthopaedic prognosis stops explaining the claim. Dr Tom Bendinger explains when a pain medicine expert should lead the evidence, why diagnosis and causation are separate exercises, and the counterfactual question that usually decides the opinion.

Imaging, Surgery and Analgesia as Poor Proxies for Pain Severity

Normal scans, successful surgery and modest medication use are often treated as proof pain isn’t severe — abnormal findings, failed surgery or heavy analgesia as proof it is. Both readings are unreliable. Pain severity has to be triangulated from the full clinical picture, not read off a single proxy.

Catastrophisation, ACEs, and ‘Disproportionate’ Pain

Disproportionate’ pain is one of the most invoked, least examined credibility markers in personal injury litigation — used whenever a presentation seems to exceed what scans or injury would predict. Catastrophisation and ACEs are two well-evidenced, non-volitional mechanisms that can produce exactly this picture without implying dishonesty.

Chronic Pain Without Demonstrable Physical Pathology

Chronic pain without physical pathology creates one of the most challenging issues in personal injury litigation. A recognised diagnosis confirms genuine symptoms — but does not by itself establish causation. This article examines how courts and experts should approach causation, evidential uncertainty, and medico-legal risk.

Chronic Pain, FND, and the Brain: Implications for Medico-Legal Causation

Chronic pain in litigation often persists despite limited structural pathology. Contemporary neuroscience shows that altered brain networks, predictive processing, and conditions such as FND can explain this persistence. This article examines the implications for medico-legal causation and expert evidence.

Chronic Post-Amputation Pain in Medico-Legal Claims

Chronic post-amputation pain is common, complex, and incompletely understood — a combination that creates real tension in medico-legal claims. Proper assessment requires clear differentiation of pain types and structured analysis of biopsychosocial risk factors. Expert evidence must help the court navigate that complexity with transparent reasoning, rather than forcing certainty where none exists.

Medicolegal Aspects of Complex Regional Pain Syndrome

CRPS is a rare but severe chronic pain condition that generates some of the most contested medico-legal claims. Diagnosis rests on clinical criteria rather than objective testing, causation is frequently disputed — particularly where the initial injury was minor and expert evidence is central to case resolution. This article examines the key evidential challenges and what sound expert opinion requires.

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