Biomedical and Biopsychosocial Approaches to Pain and Its Management

One of the most commonly used approaches to treating pain involves prescription pharmacologic therapy. Patients have been “trained” to expect a prescription for a medication that they do not have available to them over-the-counter, and clinicians are fully cognizant of patient expectations. This dynamic is rooted in the biomedical approach to treating pain in a reductionistic way: one that intends to reduce a subjective pain rating reported by the person experiencing the pain. A biomedical approach by definition presumes that pain is a purely nociceptive experience, and even though most often appropriate for treating acute pain, it is often considered the go-to solution for managing any type of pain, including subacute or chronic pain. This chapter will explore this in more detail, and also discuss the value proposition of employing a biopsychosocial approach to managing pain, emphasizing that it is more important to know and understand the person with pain than to understand the pain itself to best treat it. This chapter will emphasize the importance of the patient narrative as part of a standard pain assessment, including the consideration that fear can contribute significantly to how a person responds to pain both physically and mentally, reinforcing the idea that effective pain care involves not only a multimodal approach, but also very often an interdisciplinary one.