Following a minor meniscal injury to his right knee, a previously fit and well 58-year-old man developed profound somatisation leading to paraplegia. The patient developed a deep-seated belief that any exercise or walking would cause irreparable damage to his knee. Over the course of 2 years his, mobility reduced from active mountaineering to walking a short distance, and finally to paraplegia. Medical investigations were normal and organic causes were ruled out. Conventional therapy was exhausted, a number of medications were trialled over 5 years, including selective serotonin reuptake inhibitors (SSRIs) and antipsychotics without success. Eventually, with a combination of cognitive behavioural therapy, physiotherapy and a novel experimental therapy where the patient rolled dice and acted according to the roll results, the patient was able to literally and metaphorically get back on his feet.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515472PMC
http://dx.doi.org/10.1136/bcr-2018-227285DOI Listing

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