Biopsychosocial Model of Health – What Does This Have To Do With My Injury?
Why do different people with the same injury and diagnosis often respond to the same treatment differently and take different amounts of time to recover? The Biopsychosocial Model helps us better understand the complex experience of pain and injury.
The Biopsychosocial Model of health offers a broader holistic alternative to the traditional biomedical model of injury and illness. The biomedical model places sole focus on the biological condition, or specific musculoskeletal diagnosis and pathology, to fully explain pain and injury as the result of a single cause.
However, it is now generally accepted (and backed by a robust body of research) that overall health, pain, and illness are more than a just physical experience of a single biological or mechanical cause; they result from a complex interaction between a multitude of biological, psychological, and social factors: the Biopsychosocial Model. This model recognizes that the relationship between these domains is complex, dynamic, and unique to each individual.
The biological, psychological, and social domains of health interact with one another and with the external environment to create an individual’s unique pain presentation and determine that individual’s response to treatment, paving their road to recovery.
To clarify what this means, here are some examples of the three aforementioned domains:
Biological: Physical nature of the injury (diagnosis), degree of injury (severity), timeline for physiological healing of the type of tissue involved (e.g. bone, ligament, tendon, muscle, nerve etc.)
Psychological: Coping behaviours (substance use, meditation, refusal to seek professional help), perceptions (fears around recovery, concerns of chronic repercussions versus a positive outlook), motivation, emotions, stress levels (whether the stress is injury related of general life stress) and resilience. Research has shown that those with high levels of self efficacy (the belief and confidence in one’s ability to recover) tend to have less pain and a quicker recovery from many musculoskeletal injuries.
Social: Level of support from family and friends, socioeconomics, ability to participate in meaningful activities, contentment with work/home/personal life.
Why This Is Important To Our Patients
The Biopsychosocial model allows for a more holistic way to account for pain and injury experiences. By understanding that each individual is different and addressing psychosocial factors, treatment and prognosis can be tailored to account for all aspects important for a successful recovery.
This model also highlights the importance of a team approach to rehabilitation to thoroughly address all contributing factors and potential obstacles effectively. This is why our team includes a variety of practitioners who are all experts in their respective fields.
Persistent or chronic pain (defined as pain ongoing for longer than three months) is a great example of the need for the Biopsychosocial approach.
When pain doesn’t improve as quickly as expected, it is common to maintain focus solely on the biological factor; maybe the injury is worse than first anticipated, or perhaps it was wrongly diagnosed. However, in most cases, applying the Biopsychosocial Model to pain and working with the right practitioners can help address the condition from a holistic perspective, find the various contributing factors, and pave the road to recovery.
In summary, the Biopsychosocial approach allows us to:
- Understand the complete picture
- Recognize the importance of a person’s individual beliefs, mental wellness, and social impacts on injury, pain, and recovery
- Provide patient-centered care and improve patient outcomes
- Apply collaborative thinking and a team-based rehabilitation approach
Supporting Evidence
The Biopsychosocial Model is widely and increasingly recognized as the future of healthcare. Demonstrating its importance, the World Health Organization integrates this model in their approach for classification and prognosis of injuries and illness (Wade & Halligan, 2017).
Scientific literature also supports the Biopsychosocial Model. A recent study, involving expert clinicians and researchers in rehabilitation, identified 26 prognostic factors for recovery from acute neck pain, and 13 (a whopping 50%) of these were psychological in nature (Verwoerd, Wittink, Maissan, & Smeets, 2020). This means that the degree of tissue injury alone does not explain an injury or level of pain experienced. This supports the importance of early identification of all prognostic factors and application of targeted treatment to both treat an acute issue and prevent acute injuries or pain from becoming chronic.
How We Apply This Model at Rebalance Sports Medicine
At Rebalance, we consistently apply the Biopsychosocial Model in our plans of care. We recognize that many factors interact to contribute to health, injury, and wellness. Our collaborative multidisciplinary team is committed to providing a client-centered, holistic approach to rehabilitation to help you get better faster and get back to the things you love.
As clinicians, we believe that tailoring our approach to every unique individual we treat is critical to providing the best possible care, and we will guide you in finding the best Rebalance team members to support your recovery.
As a patient, we recommend you consider:
- All elements of your life that may be contributing to how you are feeling.
- Discussing these broader factors with your clinician.
- Accessing the right care from a knowledgeable multidisciplinary team.
- Striving to actively manage your physical, mental, and social well-being to help you recover faster from injury, build resilience for the future and continue to perform at your best.
References:
- Verwoerd, M., Wittink, H., Maissan, F., & Smeets, R. (2020). Consensus of potential modifiable prognostic factors for persistent pain after a first episode of nonspecific idiopathic, non-traumatic neck pain: Results of nominal group and Delphi technique approach. BMC Musculoskeletal Disorders, 21(1), 1–11. https://doi.org/10.1186/s12891-020-03682-8
- Wade, D. T., & Halligan, P. W. (2017). The biopsychosocial model of illness: a model whose time has come. Clinical Rehabilitation, 31(8), 995–1004. https://doi.org/10.1177/0269215517709890
Rebalance Toronto
Rebalance Sports Medicine is a multidisciplinary clinic in downtown Toronto offering physiotherapy, chiropractic, registered massage therapy, sports medicine, naturopathy, Pilates and more.