Open Access Research article

Pain drawings in somatoform-functional pain

Niklaus Egloff1*, Rafael JA Cámara1, Roland von Känel1, Nicole Klingler1, Elizabeth Marti2 and Marie-Louise Gander Ferrari1

Author Affiliations

1 Division of Psychosomatic Medicine, Department of General Internal Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland

2 Department of General Internal Medicine and Department of Orthopedic Surgery, Bern University Hospital and University of Bern, CH-3010, Bern, Switzerland

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BMC Musculoskeletal Disorders 2012, 13:257  doi:10.1186/1471-2474-13-257

Published: 20 December 2012



Pain drawings are a diagnostic adjunct to history taking, clinical examinations, and biomedical tests in evaluating pain. We hypothesized that somatoform-functional pain, is mirrored in distinctive graphic patterns of pain drawings. Our aim was to identify the most sensitive and specific graphic criteria as a tool to help identifying somatoform-functional pain.


We compared 62 patients with somatoform-functional pain with a control group of 49 patients with somatic-nociceptive pain type. All patients were asked to mark their pain on a pre-printed body diagram. An investigator, blinded with regard to the patients’ diagnoses, analyzed the drawings according to a set of numeric or binary criteria.


We identified 13 drawing criteria pointing with significance to a somatoform-functional pain disorder (all p-values ≤ 0.001). The most specific and most sensitive criteria combination for detecting somatoform-functional pain included the total number of marks, the length of the longest mark, and the presence of symmetric patterns. The area under the ROC-curve was 96.3% for this criteria combination.


Pain drawings are an easy-to-administer supplementary technique which helps to identify somatoform-functional pain in comparison to somatic-nociceptive pain.

Chronic pain; Functional pain syndromes; Pain drawing, Somatoform pain disorder