Two articles on PainSci cite Engel 1977: 1. Your Back Is Not Out of Alignment 2. What Works for Pain?
PainSci notes on Engel 1977:
This paper is the origin of the now famous biopsychosocial model of healthcare, advocating for a kinder, more nuanced and artful medicine, as opposed to the rather cold, clinical, and technical profession it had become in the middle of the 20th Century thanks to its immense science-powered successes.
Engel argued that the dominant biomedical model inappropriately reduced too many complex health concerns to biology and pathology alone (reductionist), excessively separated body and mind (dualist), and left “no room within its framework for the social, psychological, and behavioral dimensions of illness.” In short, he believed medicine had become dehumanizing, excluding the patient and their “…attributes as a person, a human being.”
Engel proposed that the BPS model could provide a “…blueprint for research, a framework for teaching, and a design for action in the real world of health care.”
Ever since publication of this landmark paper, the BPS model has been extensively interpreted and misinterpreted, used and abused and co-opted and perverted. Cormack et al describe many of the problems that emerged over the years.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
The dominant model of disease today is biomedical, and it leaves no room within tis framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- No long-term effects after a three-week open-label placebo treatment for chronic low back pain: a three-year follow-up of a randomized controlled trial. Kleine-Borgmann 2022 Pain.
- Exercise and education versus saline injections for knee osteoarthritis: a randomised controlled equivalence trial. Bandak 2022 Ann Rheum Dis.
- Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study. Kasch 2022 Spine (Phila Pa 1976).
- A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Yousef 2013 Anaesthesia.
- Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Richards 2021 Phys Ther.