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Staying Ahead of the Pain: Biopsychosocial Approach
Persistent pain is a severely debilitating condition that has a significant effect on a person’s ability to go about their normal daily activities. This can have a negative impact on one’s family, social life as well as health care services1
Staying Ahead of the Pain: Biopsychosocial Approach
Pain acts like the senses and like all sense it has an intended purpose. Pain acts as an ‘alarm’ to alert the body to injury.2
Unlike the other senses, the perception of pain is not just a physical process that results in a reaction. It also requires our brain to make a connection and learn what is happening and how we are feeling.2
Magnetic resonance imaging (MRI) have shown that many parts of the brain are active when someone experiences pain.2 These parts of the brain are also involved in processing emotions and behaviour.2
This explains why people can respond so differently to the same painful experience.2
Biological, psychological and social considerations1
Damage to the body (biological aspects), thoughts and feelings (psychological) and surroundings (social) can all contribute to the experience of pain. Being in pain can also influence each of these and in turn, cause a cycle of progressively worsening pain.2
The biological aspect
There may be changes in strength, range of motion and stability of the joint or limb as a result of experiencing pain from an injury that has occurred.2
‘Guarding’ behaviours such as limping, bracing or protecting a part of the body that has been injured, to avoid pain, can cause changes to physical functioning. They also have the potential to cause disability.2
The psychological aspect
Everyday challenges that the person with persistent pain have to cope with can leave them feeling helpless, worthless and hopeless.2 Fear and anxiety are often experienced and can lead to a vicious cycle of doing less and less activity over time.2
Those living with persistent pain can also have a higher risk of depression compared to those without pain.2 This can make it more difficult to manage the pain.
The social aspect
A person’s home life, their relationships, their financial standing, sense of community and culture, general lifestyle, work and general life stresses can have an impact on how they experience pain.2
Though social factors are often less recognised, when pain progresses, it is a result of the combination of the social, psychological and physical factors.2
The impact of persistent pain
The impact of pain does not just affect the person living with pain, but it can affect family members and caregivers.3 Relatives have reported emotional changes, limited socialising, financial challenges because of their loved one’s pain, which has contributed to a decline in their own physical, mental and emotional health.2
A whole person approach to pain management
To be able to address the many contributing factors of pain and use a biopsychosocial approach to pain management, getting help from a variety of health professionals may be helpful.2
Physical:
Participation in exercise and physical activity that is appropriate for your pain intensity can help to relieve pain and improve physical function, sleep, fatigue and mood.2
For example, gradually building exercise endurance, doing things you once enjoyed in a measured way at first can minimise pain that results from overactivity.2
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Psychological aspect:
A psychologist can help you by using tools like Cognitive Behavioural Therapy, which is recommended in pain management as it takes into account behaviors, beliefs and improves your confidence in managing your pain.4
Relaxation may include learning diaphragmatic breathing, progressive muscle relaxation, guided meditation, visualization, and stretch-based relaxation and can be helpful to reduce tension in the body.2
Mindfulness can be included in pain management therapies to decrease pain intensity and help you to cope better with pain that you can anticipate.5
Social aspects:
Choosing activities that you enjoy will help to reduce feelings of isolation.2
Using online platforms and sharing your experience and learnings on a blog can help you feel less lonely.2
Use problem solving skills to create a plan so that you can still participate in activities despite pain. For example, choosing an earlier time of day to meet up with friends for a meal rather than having late nights.2
Conclusion
Pain is not a simple affliction of one body system; it is a multifactorial condition. To manage pain successfully, a holistic approach taking into consideration the biopsychosocial factors, can continue to bring meaning and purpose back to your life again and live a good quality of life despite pain.
References:
Duenas, M., et al. A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res. 2016; 9: 457–467.
Breeden, K et al. A Biopsychosocial Approach for Addressing Chronic Pain in Everyday Occupational Therapy Practice. (2017). OT Practice, 22(13)
Ojeda, B., Salazar, A., Dueñas, M., Torres, L. M., Micó, J. A., & Failde, I. (2014). The impact of chronic pain: The perspective of patients, relatives, and caregivers. Families, Systems & Health: Journal Of Collaborative Family Healthcare, 32, 399–407
Ehde, D. M., Dillworth, T. M., & Turner, J. A. (2014). Cognitive-behavioral therapy for individuals with chronic pain. American Psychologist, 69, 153–166.
Khusid, M. A., & Vythilingam, M. (2016). The emerging role of mindfulness meditation as effective self-management strategy, part 2: Clinical implications for chronic pain, substance misuse, and insomnia. Military Medicine, 181, 969–975.
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