Biopsychosocial approach to assessment 1

Question 1

Brief psychosocial screening (ACT UP)

Answer 1

• Activities- how is pain affecting life
• Coping- what makes it better or worse
• Think- do you think you’ll get better
• Upset- depressed/anxious
• People- how do people around you respond to your pain

Question 2

Model of biopsychosocial pain

Answer 2

• Pain type
• Somatic
• Cognitive
• Emotional
• Behavioural
• Social
• Motivational

Question 3

Pain type

Answer 3

•	Assess pain intensity, quality and location
•	Determine whether pain is-
o	Nociceptive
o	Neuropathic (peripheral)
o	Central sensitisation

Question 4

Somatic dimension

Answer 4

• Physio assessment

* What structures involved?

Question 5

Cognitive dimension

Answer 5

•	Thoughts and beliefs of pain-
o	Catastrophising
o	Self-efficacy
o	Patient expectations
o	Fear avoidance
o	Patient understandings/attributions

Question 6

Emotional dimension

Answer 6

• Depression/anxiety screening questions

* Physios not qualified to diagnose, if red flags are evident, refer to GP

Question 7

Behavioural dimension

Answer 7

• Dealing with complaint
• Limitations to activities
• Avoidance
• Talking about compliments
• Nonverbal pain behaviours

Question 8

Social dimensions

Answer 8

how do others react to you and your pain. What suggestions do they make?

Question 9

Motivation

Answer 9

Could use psychological inflexibility in pain scale

Question 10

Physical and functional examination

Answer 10

•	Quantitative sensory testing-
o	Testing A-delta, A-beta and C fibres
o	Thermal, pressure, electrical, stimuli
o	Muscle ischemia
•	Pressure algometry- 
o	assess pressure pain threshold to mechanical stimuli at (primary hyperalgesia) or outside site of injury (secondary hyperalgesia)