British pain clinic practitioners' recognition and use of the bio-psychosocial pain management model for patients when physical interventions are ineffective or inappropriate: results of a qualitative study

BMC Musculoskelet Disord. 2010 Mar 18:11:51. doi: 10.1186/1471-2474-11-51.

Abstract

Background: To explore how chronic musculoskeletal pain is managed in multidisciplinary pain clinics for patients for whom physical interventions are inappropriate or ineffective.

Methods: A qualitative study was undertaken using semi-structured interviews with twenty five members of the pain management team drawn from seven pain clinics and one pain management unit located across the UK.

Results: All clinics reported using a multidisciplinary bio-psychosocial model. However the chronic pain management strategy actually focussed on psychological approaches in preference to physical approaches. These approaches were utilised by all practitioners irrespective of their discipline. Consideration of social elements such as access to social support networks to support patients in managing their chronic pain was conspicuously absent from the approaches used.

Conclusion: Pain clinic practitioners readily embraced cognitive/behavioural based management strategies but relatively little consideration to the impact social factors played in managing chronic pain was reported. Consequently multidisciplinary pain clinics espousing a bio-psychosocial model of pain management may not be achieving their maximum potential.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Behavior Therapy / methods
  • Behavior Therapy / statistics & numerical data
  • Behavior Therapy / trends
  • Biofeedback, Psychology / methods
  • Chronic Disease / prevention & control
  • Chronic Disease / therapy
  • Combined Modality Therapy
  • Culture
  • Decision Support Systems, Clinical
  • Decision Support Techniques
  • Educational Status
  • Humans
  • Interdisciplinary Communication
  • Models, Psychological
  • Musculoskeletal Diseases / complications*
  • Pain Clinics / statistics & numerical data
  • Pain Clinics / trends*
  • Pain, Intractable / etiology
  • Pain, Intractable / psychology*
  • Pain, Intractable / therapy*
  • Patient Acceptance of Health Care / psychology
  • Patient Care Team
  • Physician-Patient Relations
  • Practice Patterns, Physicians' / statistics & numerical data
  • Practice Patterns, Physicians' / trends*
  • Psychology
  • Social Support*
  • United Kingdom