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The Biopsychosocial Model of Pain

Pain is COMPLEX, and most of the time we cannot pinpoint the exact cause of the pain. Although the approach of pointing a finger at the source of pain seems simple, this method is far from the truth.

We say this because when we talk about pain, especially in the world of sports, we must also consider other systems that directly contribute to pain.

Hello, the BIO-PSYCHO-SOCIAL model!

This model was developed by George L. Engel and Jon Romano from the University of Rochester in 1977. They are widely regarded as the first to propose a biopsychosocial model. Engel’s biopsychosocial model reflects the development of disease/pain through the complex interaction of biological (genetic, biochemical, etc.), psychological (mood, personality, behavior, etc.), and social (cultural, familial, socioeconomic, medical, etc.) factors.

What do all these things written above mean?

When we talk about pain, we need to consider multiple elements to solve the problem. According to this model, pain is the result of the interaction between three main domains: biological, psychological, and social.

  • The biological domain refers to physical factors that can contribute to pain, such as injuries, inflammations, or diseases.
  • The psychological domain refers to how our thoughts, emotions, and behaviors can affect the experience of pain. For example, anxiety or depression can worsen pain, while relaxation techniques or cognitive-behavioral therapy can help alleviate pain.
  • The social domain refers to the cultural and social influences on the experience of pain. For example, cultural factors like beliefs about pain and suffering or social factors like social support or stigmatization can affect how people perceive and experience pain.

Pain, pain, pain…

I’ve been writing the word without explaining what it means!

As a definition, pain is an unpleasant sensory or emotional experience associated with potential tissue damage.

If we analyze the definition, we see that we’re dealing with an unpleasant experience. WOW! Pain is unpleasant, and most of the time, it comes with negative emotional baggage. If we go further and look at the words “SENSORY” and “EMOTIONAL,” we see that in the case of pain, emotions are attached to the sensory part. Often, the sensory part does not intersect with the emotional part—look at the visual, vestibular, or proprioceptive systems. In the case of pain, each person experiences it differently because each person attaches a different emotion to an uncomfortable state. And the last part, “POTENTIAL TISSUE DAMAGE,” pain doesn’t always mean something is “broken” or “destroyed.” You can relax and start moving when you feel discomfort.

How does this help us or our clients?

The biopsychosocial model is a tool that allows us to analyze the problem in more detail and automatically come up with a solution that is closer to the truth. We need to change the approach where back pain is caused by sitting at a desk! Back pain is caused by inactivity, a stressful boss, the rent due in 2 days, and a new diet that restricts you to only 1000 calories. When I manage to see the whole picture, I can adjust many elements for a better outcome.

If we were to create a pain guide, it should include all the elements mentioned above. So, the first thing you should do when you feel pain is to change your perception of that event.

Here we have two scenarios:

  1. You see it as something bad that paralyzes you and prevents you from doing anything, or it makes you stay at home and avoid any form of movement or interaction.
  2. You see it as an opportunity to discover new things about how your body moves, new exercises or techniques, all with the aim of changing the mindset where pain = FEAR.

After changing the emotional/psychological aspect, try to engage in as much movement as possible that doesn’t exacerbate your pain (Olympic Mobility course). Here, we’re talking about ANY physical activity where the objective is movement!

And the final part, seek help and try to resume all your daily activities. It is extremely important to address the social aspect when experiencing pain. It takes us out of that state where everything is “dark” and nothing works according to your liking.

The biopsychosocial model of pain is important to help us understand pain as a complex experience and to approach painful treatment in a comprehensive way. For example, instead of focusing solely on the physical treatment of pain, this model suggests that we should address pain in a holistic manner, taking into consideration psychological and social factors.

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