Clinical biopsychosocial physiotherapy assessment of patients with chronic pain: The first step in pain neuroscience education

Abstract

Pain neuroscience education (PNE) is increasingly used as part of a physical therapy treatment in patients with chronic pain. A thorough clinical biopsychosocial assessment is recommended prior to PNE to allow proper explanation of the neurophysiology of pain and the biopsychosocial interactions in an interactive and patient-centered manner. However, without clear guidelines, clinicians are left wondering how a biopsychosocial assessment should be administered. Therefore, we provided a practical guide, based on scientific research and clinical experience, for the biopsychosocial assessment of patients with chronic pain in physiotherapy practice. The purpose of this article is to describe the use of the Pain - Somatic factors - Cognitive factors - Emotional factors - Behavioral factors - Social factors - Motivation - model (PSCEBSM-model) during the intake, as well as a pain analysis sheet. This model attempts to clearly establish what the dominant pain mechanism is (predominant nociceptive, neuropathic, or non-neuropathic central sensitization pain), as well as to assess the provoking and perpetuating biopsychosocial factors in patients with chronic pain. Using this approach allows the clinician to specifically classify patients and tailor the plan of care, including PNE, to individual patients.

Cross‐cultural Adaptation and Psychometric Properties of the Greek Version of the Central Sensitization Inventory

“…Conventional biomedical assessment and treatment approaches have often been found to be insufficient for patients with CS/CSS . In the past few decades, a thorough clinical patient‐centered biopsychosocial assessment and treatment approach has been recommended for this difficult patient population . The ability to identify when presenting symptoms may be related to CS can lead clinicians to the most appropriate and successful assessment and treatment approaches …”

“…11 In the past few decades, a thorough clinical patient-centered biopsychosocial assessment and treatment approach has been recommended for this difficult patient population. 12,13 The ability to identify when presenting symptoms may be related to CS can lead clinicians to the most appropriate and successful assessment and treatment approaches. 14 The Central Sensitization Inventory (CSI) is a selfreported questionnaire to identify symptoms thta have been found to be associated with CS, including widespread pain pattern, sleep disturbance, hypersensitivity to stimuli, and cognitive, digestive, and urological problems.…”

Multidimensional study of orofacial chronic neuropathic pain: An experimental study in rats.

“…9 The models to study NCP are important to discover pathological processes and to search for targets aimed at the control of orofacial NCP. The use of study models seeks to reproduce pain dimensions for human extrapolation and translational research.…”

Teaching patients about pain: It works, but what should we call it?

“…The third article by the Belgium team of Wijma, van Wilgen, Meeus, and Nijs (2016) takes it a step further by discussing the clinical biopsychosocial physical therapy assessment of the patient with chronic pain. Here, they describe the use of the pain-somatic factors-cognitive factors-emotional factors-behavioral factors-social factors-motivation model (PSCEBSM model) during the intake, as well as a pain analysis sheet.…”