Two years ago I fell and broke my wrist. I've never been the same. Pain, swelling, sweating, and even strange hair growth over the back of my hand have developed. No one seems to know what's wrong with me. I've become so depressed my doctor wants to send me to a shrink. Could this all really be psychologic?

Studies show that at least 10 per cent of the adults who fracture the radial bone of the wrist develop a condition called chronic regional pain syndrome (CRPS). This used to be called reflex sympathetic dystrophy (RSD).

The condition is caused by trauma or damage to the tissues or nerves. An extreme inflammatory response develops. It causes pain that can become chronic. Many patients report increased sweating of the palm and extreme sensitivity to any touch to the hand and arm. Hair growth is not uncommon. Often it is dark, coarse hair in a swirled pattern.

There is no evidence that this condition is caused by psychologic or personality traits. Psychologic distress is certainly a normal response to a chronic pain condition of this type. Seeing a counselor or psychologist can't hurt. It may help you learn ways to cope and deal with the pain.