Biopsychosocial Factors that Perpetuate Chronic Pain, Impairment, and Disability

The biopsychosocial model provides the most heuristic account of the complex multifaceted nature of chronic pain and its associated impairment and disability. Although chronic pain, impairment, and disability are related, these are three separate constructs. In order to understand how these three constructs are interrelated, the development of pain from the acute to the chronic stage is discussed. Psychosocial factors as barriers to recovery are emphasized, including those that commonly manifest among patients receiving disability compensation. This is complemented by a review of psychometric instruments used to assess these psychosocial factors in chronic pain. Finally, the major delineation in levels of care for chronic pain is highlighted, emphasizing an interdisciplinary approach that is consistent with pain as a biopsychosocial phenomenon.