Chiropractic & The Biopsychosocial Model - Clinical Commentary
- RRS Education
Pain and disability are complex and growing problems in both developed and developing countries. Low back and neck pain specifically are two of the leading causes of disability worldwide, and account for billions of dollars in direct and indirect costs each year. Given this impact and the increasing prevalence of chronic pain, health care providers are recognizing that a model that accounts for the complexity of the patient may provide a more appropriate approach to care. Historically, disease, injury or illness have been viewed through a mechanistic paradigm that suggested problems were the result of a structural or cellular aberration. Although this pathoanatomic model allowed for the identification and eradication of many infectious diseases, it does not address the patient as a whole. The biopsychosocial (BPS) model proposes examining patients from a lens that incorporates the biological (physical or chemical alterations) and psychological (mental health and personal factors), in the context of the social determinants of health for each individual.
Research has suggested that the development of chronic pain is a complex process. Factors such as fear-avoidance beliefs, depression and anxiety, unsupportive social relationships, catastrophizing thoughts, low levels of self-efficacy and maladaptive beliefs are psychological factors that may contribute to the cycle of chronic or persistent pain. This cycle of pain and dysfunction may further be perpetuated by a clinician’s focus on a pathoanatomic diagnosis, potentially creating a reliance on passive care if a patient believes that something is ‘wrong’ that must be fixed.
The purpose of this commentary (published in Chiropractic & Manual Therapies 2017) was to summarize the BPS model and provide the authors’ recommendations for integrating it into chiropractic education and practice…LOG IN NOW OR SUBSCRIBE TO ACCESS THE FULL REVIEW!