Biopsychosocial Model of Pain
What is the biopsychosocial model of pain? It is a framework in medicine that posits biological, psychological, and sociological factors may contribute to the experience of pain.
- Biological factors represent the bodily events that activate nociceptors or cause abnormal homeostatic responses within tissue.
- Psychological factors influence how we feel, think, speak, believe, and act.
- Social factors influence our interactions with others, and our perceived role within a community.
Who Created The Biopsychosocial Model of Pain?
The Biopsychosocial model of pain was introduced to the medical community in 1977 by George Engel. Engel despised the biomedical model and invested considerable energy and time to replace it. While he was not successful in his attempt, his efforts significantly influenced the wellness industry the world over.
When I first learned about George Engel, his life’s work reminded me of Asclepiades of Bithynia. Both were well ahead of their time, heavily invested in the care of their patients, and wanted to transform the medical industry. Though separated by thousands of years, these two men are kindred spirits, for their compassion, analytical mind, and drive to improve patient care.
What is the Biomedical Model of Pain?
The biomedical model views pain as the direct result of physical injury, disease, or dysfunction in the body. It uses imaging and tests to detect measurable, physiological factors then treats them with pharmaceutical and surgical interventions. The biomedical model of pain states that,
- Pain has a single cause,
- pain is an indication of damage,
- chronic pain means the body is still damaged and cannot be cured.
The biomedical model is still in use by many within the healthcare industry.
Biomedical vs Biopsychosocial
The biomedical approach searches for a single cause of pain, then attempts to remedy it with pharmaceutical or surgical interventions. Its primary goal is to treat disease with curative monotherapies heavily reliant upon anatomical and biomechanical principles that address it on a cellular or molecular level. Patient management relies upon medicine-first course of action, with limited physician engagement. The biomedical approach tends to perceive physical activity with a higher degree of caution while encouraging it, and often fails to recognize the value of preventative medicine.
The biopsychosocial approach acknowledges that there may be many biological, psychological, and sociocultural factors affecting a patient’s pain. Rather than focusing solely on the disease, it uses a holistic approach that treats the whole person, especially in regard to how the brain interacts with the body. Unlike the biomedical model which tends to use an approach that wants to “cut out, turn off, or replace” the BPS model aims to retrain how the brain perceives pain, touch, and movement. It promotes physical activity, encourages self-management, personal advocacy, and rehabilitative therapies.