We do treat pain as psychological.
The trouble is, it takes a huge amount of buy-in to get a patient on board for this approach without them storming out thinking that you’ve told them their pain is made-up.
This is true, and the problem extends to many areas of neurology and psychiatry. The brain doesn’t know or care that we threw up some artificial divide and decided some things are “mental” and some are “neurological.” The brain is the brain is the brain. Functional neurologic disorders for instance are one of the most common reasons people see a neurologist, and most people recover really well. But the conversation can go terribly if not done well even though it’s good news and the prognosis is good. Having a careful conversation and introducing the concepts well is so important to get buy in so they can get access to therapies and get better.