The biopsychosocial effects of chronic pain on the patient: clinical implications

The biopsychosocial effects of chronic pain on the patient: clinical implications

Sažetak

Chronic pain is a widespread medical and social issue, yet it remains deeply misunderstood by many medical professionals. The biomedical model of pain fails to differentiate between acute and chronic conditions of pain, which often leads to unsuccessful treatment of patients. Unlike acute pain, chronic pain is associated with functional and structural changes in the brain. Structural and functional brain changes might make it more difficult for chronic pain patients to ignore uncomfortable sensations and make them prone to misattributing harmless sensations to tissue damage. Chronic pain conditions also carry certain psychological and social burdens which are often ignored in modern medicine despite research clearly showing there is a need to address them. Chronic pain patients often suffer from depression and anxiety, which makes them more prone to having irrational thoughts about the nature of their condition. Maladaptive thoughts impede the patient’s ability to be consistent with their therapy and see improvement. These issues are often exacerbated by a lack of social support. Cognitive-behavioural therapy and its alternatives have proven useful in many cases of chronic pain, and something as simple as a short education program by primary physicians might improve the patient’s symptoms. However, education of medical professionals on the intricacies of chronic pain is severely lacking. They are the first line of defence against the patient’s warped perception after the initial injury, and it is necessary to change their approach to one which considers psychological and social aspects of the condition, and not merely biomedical. This review considers some of the major elements which add to the complexity of chronic pain conditions and aims to draw clinical implications based upon them.

Key words: biomedical model, biopsychosocial model, chronic pain, clinical implications

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