Reconfiguring the biomedical dominance of pain

Time for alternative perspectives from health promotion?

Dados Bibliográficos

ID22945485
AutoresMark I Johnson (0000-0002-9421-9622, Leeds Beckett University, autor correspondente), Antonio Bonacaro (0000-0003-4475-5280, University of Suffolk), Emmanouil Georgiadis (0000-0001-6166-0975, University of Suffolk), J Woodall (0000-0003-1989-3999, Leeds Beckett University)
Ano2022
Volume37
Fascículo4
Data de publicação2022-08-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoHealth Promotion International (JOURNAL)
Identificadores do periódicoISSN: 0957-4824 • E-ISSN: 1460-2245
EditoraOxford University Press (OUP) (PUBLISHER)
DOI10.1093/heapro/daac128
PMID36102475
OpenAlexW4295757908
IdiomaEN
Citações recebidas4
Referências citadas45

Strategies to reduce the burden of persistent pain in society are rooted in a biomedical paradigm. These strategies are located downstream, managing persistent pain once it has become a problem. Upstream activities that create social conditions to promote health and well-being are likely to help, yet health promotion discourse and research are lacking in pain literature. In this article, we argue that the subjective nature of pain has not sat comfortably with the objective nature of medical practice. We argue that the dominance of the biomedical paradigm, with a simplistic ‘bottom-up’ model of pain being an inevitable consequence of tissue damage, has been detrimental to the health and well-being of people living with persistent pain. Evidence from neuroscience suggests that bodily pain emerges as a perceptual inference based on a wide variety of contextual inputs to the brain. We argue that this supports community, societal and environmental solutions to facilitate whole-person care. We call for more salutogenic orientations to understand how people living with persistent pain can continue to flourish and function with good health. We suggest a need for ‘upstream’ solutions using community-based approaches to address cultural, environmental, economic and social determinants of health, guided by principles of equity, civil society and social justice. As a starting point, we recommend appraising the ways human society appreciates the aetiology, actions and solutions towards alleviating persistent pain.

Chronic pain · Health care · Political science · Psychiatry · Public relations · Complementary and Alternative Medicine Studies · Empathy and Medical Education · Health, psychology, and well-being · Law · Medicine · Psychology