Biopsychosocial Model in Physiotherapy

In healthcare, we strive to treat every person holistically, not just the injury in isolation. A person is more than just an ankle or a back. Patients are people with frustrated employers expecting them to return to work. They are people with families who expect them to cook, take their children to school and play with them after. Maybe they are people with impatient coaches who expect them to return to sport. The people in our lives are not always as understanding and supportive as we want them to be. Often we hear stories similar to these where patients are not given the environment or time they need to heal and family members or employers often tell our patients that they are “over dramatic” and that the pain is “in their head”. Therefore, your physiotherapist may be using the biopsychosocial model when attending to injuries and pain.

Biopsychosocial is simply broken down as:

biology (your physical health, actual or potential tissue damage due to injury and genetic factors)

psychology (coping mechanisms, perceptions, previous pain experiences, expectations for recovery)

social/environmental (home/work environment, stress)

Even if you do not realise it, pressure from work, fear of movement, poor expectations of recovery, lack of understanding of one’s injury etc. can be a factor contributing to one’s pain experience and may affect healing.

The mind has a significant role in both the presentation and progression of injury and the recovery process. Coping skills, beliefs about one’s injury, work or home stress may delay recovery while positive environments and ideas can enhance recovery.

Each session is an opportunity for the patient to engage with their physiotherapist and allow the physiotherapist to understand the influence of the patient’s context – Stress, anxiety, fear which may limit the patient from performing otherwise normal daily activities and participate in daily life. While every physiotherapist will perform an evaluation to assess for physical changes such as; muscle power, joint range of motion, pain, movement patterns and the impact of inflammation or delayed healing, they will also ascertain which activities you would otherwise perform in the absence of pain or injury in order to better formulate treatment goals and guide treatment choices.

Each person has something in which they participate, either big or small which requires a multitude of activities and movements which, once hampered by pain or injury, participation may not be so simple.  Losing control of our lives and feeling powerless to pain or injury can change our beliefs about what we can accomplish in our day to day lives. Everyone will have arrived at the physio’s rooms with some expectations and beliefs about their injury and it is the role of the physiotherapist to discuss openly with their patient about treatment goals. The patient should always be allowed to participate in their goal setting and treatment plan together with advice and input from their physio and arrive at a mutual understanding of how best to progress in a way that is realistic and achievable.

Sean Croxford
Physiotherapist ( KPSMC )

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