The rise of the Biopsychosocial model of pain
There is a common belief among practitioners that incorrect alignment while exercising, or poor posture, structural imbalances and asymmetries, are the cause of painful musculoskeletal conditions. However, this mode of thinking has been eroded by research in the past two decades. Structural asymmetries are normal variations and cannot predict back pain, the body has a surplus capacity to tolerate structural variations and correcting postural asymmetries and imbalances is not clinically attainable and unlikely to change the future course of a lower back condition (Lederman, E (2010) The fall of the postural-structural-biomechanical model in manual and physical therapies: Exemplified by lower back pain).
The Biopsychosocial model (BPS model) emerged in the 1970s as a more comprehensive and whole person approach to understanding health and illness. It recognises that health and illness are the result of an intricate interplay between biological, psychological, and social factors. This model emphasises the importance of considering the individual's unique circumstances and experiences when assessing their health.
The BPS model recognises that there is no single cause for back pain. Pain is not just the result of damaged tissues but also complex interactions between multiple factors such as social, psychological, cultural, and environmental factors that impact a person's health. For example, a person's social environment and support network can impact their mental and physical health outcomes. Likewise, a person's cultural background and beliefs can shape their experience of pain and impact their access to healthcare.
The BPS model requires a more client centered approach to healthcare, recognising that patients are not just a collection of symptoms, but unique individuals with their own set of circumstances and experiences. By taking a more comprehensive approach we get to better understand the underlying causes of pain and develop more effective treatment plans.
