What is BPS? It's the biopsychosocial model of wellness that can help reduce chronic pain. I'm Leonie Macpherson of Bodyology Massage. Let me explain BPS factors...
So, how does chronic pain develop in the first place? Pulling a muscle tells the brain to make the area hurt in an attempt to protect the area, but sometimes the ‘alarm’ does not switch off. Ninety percent of chronic back pain is due to oversensitivity. A sign of oversensitivity is when a client complains that their pain moves around the back, such as from the lumbar area to the shoulder, or if it is worse when the patient is stressed. So, in a nut shell… ‘pain’ and ‘damage’ are NOT the same thing.
We know that everything in the body heals within 6 months, after which we’re dealing with a nerve sensitivity, or pain issue. So we need to dis-anchor the link between the structural threat, and the perception of that threat. While traditional biomedical models of clinical medicine focus on pathophysiology and other biological approaches to disease, the BPS approach emphasises the importance of under-standing human health and illness in their fullest contexts. The BPS approach systematically considers biological, psychological, and social factors and their complex interactions in understanding health, illness, and health care delivery.
There are natural capacities that we possess; I.e., the body prefers to be ‘well’ but some subconscious activity can interfere with its ability to get on with the job of healing us, such as to reduce our cortisol level. So when a client’s pain does not go away once the injury has healed, massage therapists need to use a bit of psychology. I am quite intuitive and can often 'feel' (both intuitively and via palpation) when someone is carrying their pain around with them. If I get the client talking, a mental or emotional ‘clue’ often arises in conversation.
Studies have been done to see if chronic pain can be better managed with psychology as opposed to manual therapies such as physiotherapy or chiropractic intervention. One study was called ‘Graded Sensory Motor Retraining’ (a 12-step program), and the other was called ‘Pain Reprocessing Therapy’ (a type of CBT). Both theories had similarities. After the trials, it was determined that two thirds of the participants became pain free, or nearly so!
I have learnt that chronic pain is like having a particularly touchy car alarm; for example, if someone tries to break into your car, the alarm will start blaring. That's fine — it's a useful warning that something's awry, but if a cat leaping onto the bonnet also sets it off, the alarm isn't serving a useful purpose (unless you really hate paw prints on your windshield). It is estimated that about 90% of chronic back pain is due to this oversensitive alarm, and not driven by a specific pathology or physical injury in the back. And it’s interesting to know that degenerative change and compressed discs don’t always cause pain, so telling someone that it DOES cause pain can make them feel threatened, which in turn can induce feelings of pain. Therefore, all medical professionals need to be careful how they communicate with their client.
Finally, when I learnt that opioid drugs (pain killers) have been proven to ‘fan the flames’ of pain, I decided to avoid recommending them to my clients. Instead, I use the BPS model of healing during all my treatment sessions and include relaxation techniques with every massage. That’s why if you come to me for a focussed remedial massage, you may also receive a gentle scalp massage and some relaxing techniques for the whole body. A little bit of nurturing goes a long way.
