“Biopsychosocial” is a big word thrown around a lot when the medical world talks about persistent pain and other persistent health conditions. Below I discuss this term and how it relates to persistent pain assessment and treatment or management.
Pain should ease once an injury has healed or we have recovered from an illness. But sometimes the pain doesn’t go away and we call this chronic/persistent pain. The pain experience involves all our body systems. Ongoing pain can be as a result of a number of factors including miscommunication between the brain and the nerves as well as these systems changing their behaviour (e.g. sensitivity to incoming messages). It’s like an alarm going off for no reason but the alarm is still very loud and very real! Persistent pain is pain that doesn’t go away even after the body has healed – it lasts for more than 3 months and can be caused by a number of factors, including injury, disease, age and psychological factors.
In the past, pain was only treated by identifying actual physical body “damage”. But this approach often failed and currently 1 in 5 people around the world have persistent pain! It is a complex condition and a major contributor to disabilities. It is influenced by a wide range of factors, and for this reason we now approach persistent pain from a “biopsychosocial” point of view.
So, you might be asking what the word “biopsychosocial” actually means? The biopsychosocial model acknowledges that pain is not just a physical sensation, but also a psychological and social experience, with someone’s life context influencing their pain experience.
The following explains how different parts contribute to “context”:
BIO
Biological factors: These include the underlying medical conditions, as well as pain genetics, pain sensitivity and pain processing.
PSYCHO
Psychological factors: These include thoughts, feelings, and beliefs about pain, as well as coping skills and stress levels.
SOCIAL
Social factors: These include social support networks, work environments, and cultural beliefs about pain.
All pain should be investigated. Using the biopsychosocial approach means that the pain experience is looked at comprehensively and holistically. It is an approach that recognises that no single treatment will be effective for everyone. Instead, the goal is to develop a personalised treatment plan based on a thorough assessment. Advances in science mean that suitably trained health care professionals can identify evidence for the different pain mechanisms which helps to target treatment. This doesn’t mean that the treatment is simple or that it isn’t going to take patience, persistence and courage, but it can help someone become a successful self-manager of their condition.
Well, you might be asking what the different treatments are with the biopsychosocial approach. Because it is such a comprehensive model, there is normally more than one health care professional involved.
Some of the treatment options may include:
- Physiotherapy
- Occupational Therapy
- Nutrition
- Cognitive behavioural therapy (CBT)
- Acceptance and Commitment therapy (ACT)
- Mindfulness-based stress reduction (MBSR)
- Exercise rehabilitation
- Pilates or Yoga based exercises
- Support groups
- Medication
There are quite a few group-based programmes that help people with persistent pain to upskill in these different areas and make changes to their lifestyle. We also know that group-based work might not suit everyone’s life, so there is also the option to do one on one sessions with a trained persistent pain practitioner. And as I mentioned previously, with patience, persistence and courage it is possible to return to a more active and fulfilling life.