Beyond biopsychosocial: The keystone mechanism theory of pain.

Brain Behav Immun

Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany; Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Germany; Pain Research, Department of Surgery and Cancer, Imperial College, London, UK; Neurophysiology, Mannheim Centre for Translational Neuroscience MCTN, Medical Faculty Mannheim, Ruprecht Karls University, Heidelberg, Germany.

Published: November 2023

AI Article Synopsis

  • Pain is a personal experience that varies significantly between individuals, making it a tough challenge for healthcare professionals in terms of treatment and management.
  • The biopsychosocial model (BPSm) has shifted the focus from just biological aspects of pain to include psychological and social factors, highlighting how these elements interplay in individual pain experiences.
  • However, the authors argue that while BPSm is a solid framework, it's not enough for tailored treatments, and they propose a new "keystone model of pain" that balances comprehensive understanding with practical approaches to improve individual care.

Article Abstract

Pain is a deeply personal experience, with interindividual differences in its chronification and treatment presenting a formidable healthcare challenge. The biopsychosocial model (BPSm) has been hugely influential within nascent attempts at precision pain medicine, steering the field away from a reductionist biomechanical viewpoint and emphasising complex interactions of biological, psychological, and social factors which shape the individuality of pain. However, despite offering a strong theoretical foundation and holistic perspective, we contend that the BPSm remains limited in its capacity to deliver truly mechanistically informed treatment of pain. We therefore propose the keystone model of pain which offers a pragmatic balance between the dimensionality expansive BPSm and overly reductive approaches, providing both theoretical and practical advantages for the transition from treating populations to individual people.

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Source
http://dx.doi.org/10.1016/j.bbi.2023.08.018DOI Listing

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