Understanding Pain Management

10 Nov, 2021
Understanding Pain Management

It’s interesting to observe in clinic that when patients are in a degree of pain their perception of the pain is influenced by those around them, the language that is used and their social background.

In the 1990’s an orthopaedic consultant by the name of Gordon Waddell proposed that back pain, in particular, was bigger than the sum of its parts. He proposed a model of understanding that at the time made huge inroads into how we manage and understand pain.

The model he proposed was called the biopsychosocial model of pain. He suggested that pain could be looked at as having three, equal areas that can change its mechanism and perception and therefore as healthcare professionals we should address all three equally.

Bio – this is proposed as being the biological part, in other words the injury, its mechanism and the area that has sustained the problem. As health care providers we’re good at looking at this part, we examine the area, formulate a working diagnosis, run tests and come up with a management plan that focuses on it.

Psychological – this part is reference to the concept that the patient themselves influences their own pain, so stress, thoughts, feelings, pressure to be at work, previous experiences of pain, all change how we think about the pain and ultimately how our brain modulates it.

Social – this area is interesting. Gordon Waddell suggested that the patient’s environment, including work, family, social, housing, diet, all have an impact upon how our body and brain perceive the pain that is being experienced.

It was suggested that all three areas have equal weighting and should be addressed equally when managing pain. This is why therapies such as CBT and counselling may be advised for pain patients and also why we as healthcare providers may ask questions regarding your current circumstances. We’re trying to better understand so that we can support you in your decision making and in your management.

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