The biopsychosocial approach to musculoskeletal issues

Fancy words for something not really that difficult to understand!

Biopscyhosocial (BPS) just means bio-logy, psycho-logy & socio-logy. It is an approach to healthcare directly contrasted with biomedical approaches. Biomedicine is premised on identifying a biological object for therapeutic intervention. For example a blood test reveals you have a parasitic infection, an x-ray reveals you have a fractured femur, and an MRI reveals you have torn rotator cuff tendons etc. In each of these situations, the biomedical diagnosis informs the correct intervention or treatment, along with an approximate timeframes for healing. This is a "contract" many people know and trust, but what happens when this contract fails, or is only partially fulfilled?

It's important to consider that biomedicine developed in a completely different era when "infectious diseases" were the biggest killers, which was roughly around the 18th to 19th centuries. Biomedicine is a type of medicine that developed out of amazing breakthroughs in sciences like microscopy and microbiology, and eventually out of modern imaging technologies like x-ray, ultrasound, MRI, CT. With that background, it becomes easier to appreciate how biomedicine works; how it works brilliantly when it can identify an obvious target based on some technology, but also how it can fail miserably, when it can't detect a target or that target is open to speculation.

Many modern ailments have a lifestyle component, meaning what we do to ourselves or how we choose to live, has some impact on how we feel and function. Stuff like sleep, diet, exercise, alcohol intake, stress & work, state of our finances & relationships etc., that many people intuitively understand have an effect. Another way of saying this, is that influence of lifestyle is difficult to determine with any certainty and that biomedicine doesn't deal well when people present with ailments that could just as easily be lifestyle-related as they could be indicative of an underlying medical-type issue. This is where the BPS approach tries to address this "gap" by helping to provide a framework for people to work out what lifestyle factors could be addressed for optimal results. For many pain and musculoskeletal issues, especially those without an obvious biomedical target, the BPS approach will likely to prove superior over time; it is an approach that fits well with the lifestyle approaches of many manual and exercise therapies.

Reference:

Engel, GL 1977, "The need for a new medical model: A challenge for biomedicine," Science, vol. 196, no. 4286, pp. 129–136.