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Biopsychosocial model

Integrative approach

Our position with regards to the use of drug-based medication for the treatment of pain is that, in general, they are acceptable (or even essential) in the short term and have little use in chronic pain. There are a few exceptions to this, which include cancer pain.

Research has shown that, in the long term, pain medication such as anti-inflammatories and all types of analgesics can be ineffective and can have multiple side effects some of which can lead to permanent disability and chronic conditions and, paradoxically, induce pain.

Our biopsychosocial and multi-disciplinary approach to pain management is in line with the best existing evidence accepted world-wide as the most effective mechanism for the management of pain.

We do not prescribe drugs. Instead, when necessary, we suggest natural alternatives which have been shown to positively aid the patient’s healing process after a careful assessment of the possible contraindications and interactions which may present with existing medication.

We may also suggest nutritional interventions including supplementation and dietary changes.

Whenever possible, we involve the patient’s GP in this process and work together to achieve the best and fastest route to a positive outcome for the patient.


At Intlife we think it is important to evaluate every treatment, not only the efficacy of different therapies for different types of pain but also to contribute towards the overall evaluation of presented pain in different types of settings and pain management protocols.

As we follow a biopsychosocial model, we think that any evaluation needs to include not only quantitative but also qualitative markers. This allows us to measure pain intensity, its relationships with patients' mental/emotional health, and its effects on quality of life and work.

For this purpose we have studied the best validated evaluation systems available and adapted them through amalgamation and refinements in order to best match our specific model, aims and objectives.

The main evaluation tools that we have studied were the:

   * Brief Pain Inventory (Short Form)

   * Glasgow Pain Questionnaire

   * Örebro Musculoskeletal Pain Questionnaire

   * Oswestry Disability Index

   * Pain Beliefs And Perceptions Inventory

   * Pain Outcome Questionnaire (US Department of Veteran Affairs)

   * Quebec Back Pain Disability Scale

   * West Haven-Yale Multidimensional Pain Inventory

We deemed necessary to summarise the above validated evaluation systems to shorten administration and measurement time as well as to provide one single evaluation mechanism which takes into consideration important biopsychosocial markers as well as ' bottom line' markers useful for the assessment of our services with regards to effectiveness of treatments, patient satisfaction and cost effectiveness.

Pain intensity is measured simply through the use of an adaptation of the standard Numeric Rating Scale (NRS) and Faces Pain Scale (FPS) using a 0-10 subjective measurement of intensity aided by visual icons, adapted to take into consideration assessment of patients with verbal communication and learning difficulties.

Pain Questionnaires and forms (non-validated)

Pain Questionnaire

Review Form

Intlife Pain Assesment Card

Integrates elements of:

Descriptive Pain Questionnaire (eg McGill)

Faces Pain Rating Scale (eg Wong-Baker) includes facial expressions (body language)

Verbal Pain Scale (where ‘No pain' (0) and 'worse pain' (10) are kept separate

Numeric Pain/Rating Scale

Takes account certain universal synaesthetic traits

  •  V shape' indicator  (from narrow to wide)
  •  Vertical direction
  •  Face sizes from small to large

Number (physical) sizes from small to large

Evidence of therapeutic effectiveness

Evidence for any health interventions is paramount but we do not 100 per cent rely on results derived from the RCT gold standard as, in my view, it has not itself shown to be a reliable enough evaluation tool for a variety of reasons.

Instead, we utilise a wider range of evaluation mechanisms (including RCT), many of which can be found in the Kings Fund’s report ‘Evidence and Public Health

Some of the research evidence for the effectiveness of therapies used at Intlife Pain Management can be found here.

"The thing always happens that you really believe in; and the belief in a thing makes it happen."
Frank Lloyd Wright
Although the NHS provide support for chronic pain through a number of outlets, the McEwan Report (commissioned by the Scottish Executive) shows that this service can be fragmented, inflexible and lacking in resources.

Pain management in the NHS, with a few exceptions, tend to focus on relieving pain symptoms through the use of a handful of tools (mainly physiotherapy, psychology and medication) rather than dealing with its source . Drugs such as pain killers and anti-inflammatories often have unpleasant if not dangerous side-effects.
CHRONIC PAIN. Intlife Pain Clinic.